A Clinicopathological study of esophageal varices. Relevance to the structure of drainage vessels from esophageal varices.:Relevance to the structure of drainage vessels from esophageal varices

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We examined 16 autopsy cases with cirrhosis of the liver having untreated esophageal varices. A barium solution with gelatin was injected from the left gastric vein. In angioarchitectural study, there were numerous small perforating veins which connected the submucosal veins to the adventitial veins. In the morphometric study, sections from five levels weres tudied: 1, 3, 5, 7 and 9 cm above the esophagogastric junction. The total area of variceal vessels was measured and compared among each sections. The pattern of the changes in total variceal area was categorized into three groups. Seven cases fell into the unchanging type, seven into the tapering type, and two into the abruptly diminishing type. Both of the two cases with the abruptly diminishing type had a large perforating vein in the lower esophagus. This perforating veins appears to divert the esophageal variceal blood flow into the adventitial and paraesophageal veins.
社団法人日本肝臓学会の論文