The Demonstration of Porta-Pulmonary Anastomoses in Portal Cirrhosis with the Use of Radioactive Krypton (Kr85)

Abstract

VENOUS anastomoses connecting the portal and pulmonary veins have been shown in cirrhotic patients by post-mortem injection,¹ and there has been considerable speculation concerning their possible significance in life, particularly as a cause of arterial oxygen unsaturation and finger clubbing in patients with cirrhosis.^{2 3 4 5} Radioactive krypton (Kr⁸⁵) solution, when injected into a peripheral vein, is blown off in the expired air as it reaches the alveolar surface of the lungs (Fig. 1). This has led to its use to demonstrate intrapulmonary arteriovenous shunts, which would allow krypton to bypass the alveoli and so reach a peripheral artery. In normal . . .