Studies on Cirrhosis of the Liver

Abstract

Intrahepatic blood vessels and intrahepatic shunted blood vessels were investigated in 7 human autopsied cirrhotic livers by means of shunted blood vessels in the autopsied cirrhotic livers by means of vascular acrylic resin casting, the injection of different colored gelatin through the vessels, and the histological examination of serial sections. In all the cirrhotic livers, the changes were most prominent in the hepatic veins, which were compressed by the regenerated nodules of various sizes, became tortuous, and were reduced in number. The portal vein was found less affected than the hepatic veins, but some of its branches were arranged in a basket-like fashion around the nodules. The septums contained many blood vessels with broad lumen, which were considered to derive from surviving sinusoids. It is reasonable to presume that the porto-hepatic venous anastomoses develop from the pre-existing sinusoids included in the septums. Anastomoses between the portal and hepatic veins were demonstrated in 5 of 7 specimens. Grossly visible porto-hepatic venous anastomoses were less frequently observed than microscopic anastomoses measuring form 8 microns to 100 microns in diameter. Histological studies of the serial sections revealed porto-hepatic venous anastomoses in 2 of 6 specimens. Three-dimensional figure of the porto-hepatic venous anastomosis was demonstrated in a reconstructed paraffin model. Histological examinations of the livers of 5 rats with cirrhosis due to carbon tetrachloride, which were injected with different colored gelatin, revealed the flattening and tortuosity of the hepatic veins in all rats, and porto-hepatic venous anastomoses in 4 of 5 rats.