Characterization of portosystemic collateral vessels

Mahros, Aya M.; Mohammed, Reem M.; Sewifee, Youssef M.; Ibrahim, Hamdy M.; Salem, Ahmed H.

doi:10.4103/JCMRP.JCMRP_84_18

Characterization of portosystemic collateral vessels

Authors

Abstract

Background
Portosy stemic collateral veins (PSCVs) are a consequence of the portal hypertension that occurs in chronic liver diseases and are responsible for numerous complications, including bleeding esophageal and gastric varices and hepatic encephalopathy. Few studies have evaluated the rare types of PSCVs. Our study characterized rare type of portosystemic collaterals by the use of multislice computed tomography (MSCT) and developed a novel classification of splenic collaterals: Assiut classification of splenic collaterals. This is considered a unique study in Egypt for rare type of PSCVs, which has been ignored for a long time.
Patients and methods
This case–control study was performed in Assiut University and Al-Rajhi Hospitals. We recruited 100 patients, comprising 50 patients with cirrhosis with collaterals and 50 patients without as detected by using MSCT.
Results
A total of 94% of the cirrhotic patients with collaterals (n = 50) had splenic collaterals. Splenic collaterals were classified according to their site (in relation to the splenic hilum), shape, and in accordance of their existence. Hepatocellular carcinomas were associated with development of collaterals in 88.2%. There was no statistically significant difference in the splenic size between patients with and those without collaterals.
Conclusions
Splenic collaterals are the most common types of collaterals. The clinical significance of the site and shape of splenic collaterals (The Assiut classification of splenic collaterals) needs to be investigated. MSCT provides accurate delineation of the distribution and extent of PSCVs.

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