FUNCTIONAL ANATOMY OF THE PORTA-SYSTEMIC COMMUNICATIONS

Abstract

THE CURRENT renewed interest in the problems of portal and caval obstruction prompts a reexamination of the anatomy of the communications between the portal and the systemic veins. This report is based on roentgenography and dissection of the communications after their postmortem injection with barium sulfate solution via the femoral veins and inferior caval system in human subjects. The study affords a basis for evaluation of the relative importance of the various possible collaterals. Briefly, the findings indicate that the deep pathways in the pelvis, abdomen and thorax are normally patent and are of greater importance than the anterior parietal ones. The role of porta-systemic communications as collaterals in portal obstruction will be discussed at length. Briefer attention will be paid to the utilization of the portal system as a collateral pathway after obstruction of the venae cavae. HISTORICAL STATEMENT The normal existence of multiple porta-systemic connections has been known