1999 Volume 55 Issue 2 Pages 30-33
It is important to detect portal systemic system for selecting the treatment of solitary gastric varix. Arterioportography (AP) et al has been mainly performed to detect portal systemic system. In recent year, three-dimensional computed tomography (3D-CT) et al as less invasive methods have been also performed. The purpose of this study is to compare between the usefulness of AP and 3D-CT to detect gastrorenal shunt as the portosystemic system of solitary gastric varix. Seven patients in whom gastric varix were endoscopically demonstrated were examined. Out of seven, 3 had gastric varix without esophageal varix and four did gastric varix with one. As a result, in all 3 gastric varix without esophageal varix, gastric varix and gastrorenal shunt were detected by both AP and 3D-CT. However, in all 3 cases, inferior phrenic vein connected with gastrorenal shunt was detected by only 3D-CT. In all cases of 4 gastric varix with esophageal varix, gastric varix was detected by AP. However, In 2 cases out of four, gastrorenal shunt was detected by AP. In all 4 cases, gastric varix and gastrorenal shunt were detected by 3D-CT. In all 4 cases, inferior phrenic vein connected with gastrorenal shunt was detected by only 3D-CT. In all 7 cases, the orifice of gastrorenal shunt to renal vein was in detail detected by 3D-CT. Therefore, it is thought that 3D-CT is more useful to detect inferior phrenic vein connected with gastrorenal shunt and the orifice of gastrorenal shunt to renal vein than AP.
