Cineportography and Dynamics of Portal Flow Following Shunt Procedures

Abstract

For many years the study of portal flow dynamics was limited to indirect methods because of inaccessibility of the portal vessels. The introduction of percutaneous splenoportography by Abeatici and Campi¹ in 1951 was a major advance which permitted, without operation, portal phlebography, estimation of splenic pulp pressure, preoperative determination of the patency and suitability of veins intended for portal systemic shunts, and postoperative determination of shunt patency. Atkinson et al.,² Ekman,³ and others have employed this technique in estimating the velocity of flow from the spleen to the portal vein bifurcation, using timed serial films. A transit time of 1-2 seconds was considered normal. They estimated the velocity in normal subjects to range from 10 to 24 cm. per second, with a mean of 18 cm. per second. In patients with chronic portal hypertension, the velocity ranged from 4 to 20 cm. per second, with a mean