Splenic and portal venography

Dreyer, Barend Jansen van Rensburg

Splenic and portal venography

Doctoral Thesis

1952

Abstract

In 1945 Blakemore and Lord published their work on the treatment of Banti's Syndrome by anastomosing the splenic to the left renal vein, or the portal vein to the inferior vena cava. In the same year Whipple (1945) classified portal hypertension into cases with an obstruction in the portal system outside the liver, and those with a block inside the liver, the result of hepatic fibrosis. The cases with extrahepatic blockage of the portal circulation present clinically as cases of Banti's Syndrome. In this latter group repeated haematemeses are a common, and often fatal symptom. The operation of portacaval anastomosis has as its main object the lowering of the pressure in the portal system, with a reduction in the frequency, and severity of the haematemeses. The operations are difficult and dangerous, and the patients suitable for operation must be selected carefully. The exact site of obstruction causing portal hypertension must be determined either at, or preferably before operation, as it will determine the type of operation. Thus an anastomosis between the portal vein and the inferior vena eava will be useless if haematemeses are the result of obstruction of the splenic vein.