Abstract
Portal hemodynamics was studied using digital subtraction angiography in 302 patients with esophageal varices. 1) Left gastric vein was depicted in 47% of F1 cases, 66% of F2cases, 84% of F3 cases, and short gastric veins were depicted in 13%, 21% and 24% respectively, by superior mesenteric arteriography and splenic arteriography. Esophageal varices were demonstrated in 97%, 100% and 100%, respectively by left gastric arteriography. 2) The direction of left gastric vein was hepatopetal in 47%, to and fro in 23%, hepatofugal in 23%, and undetermined in 7% of F1 cases. As the degree of esophageal varices increased, the incidence of hepatopetal cases and to and fro cases were decreased, and that of hepatofugal cases was increased. 3) According to their hemodynamics, esophageal varices were classified into two groups, “left gastric artery dependent esophageal varices”, which were mainly supplied with the blood flow of upper gastric area, and “mixed type esophageal varices”, which were supplied with portal blood flow and the blood flow of upper gastric area. The former filled about a half of F1 cases, one third of F2 cases, and one sixth of F3 cases. The latter filled about a half of F1 cases, two thirds of F2 cases, and five sixths of F3 cases.
