Objective To investigate the spiral CT manifestations of the collateral circulation pathways resulting from splenic vein occlusion (SVO) duo to pancreatic diseases. Methods The CT imaging and clinical data of 33 cases of pancreatic disease with SVO, including 28 cases of pancreatic carcinoma, 3 cases of acute pancreatitis and 2 cases of chronic pancreatitis, were retrospectively analyzed.
Results Tortuous and dilated vessels were observed in the areas between splenic hilum and gastric fundus and/or along the gastric greater curvature in all 33 cases. In isolated SVO cases, the short gastric vein (SGV, 86%)，coronary vein (CV, 79%)，gastroepiploic vein (GEV, 79%) and gastrocolic trunk (GCT, 57%) were varicose and dilated. While in nonisolated SVO，other collateral veins such as the right superior colic vein (RSCV, 37%），middle colic vein (MCV, 37%） and posterior superior pancreaticoduodenal vein (PSPDV, 21%） were seen as well.
Conclusion The two predominant collateral pathways of SVO are ①SGV→gastric fundal veins→CV， and ②GEV→GCT→SMV. They have characteristic imaging features on spiral CT and are of clinical significance in both preoperative staging of pancreatic carcinoma and the evaluation of pancreatogenic segmental portal hypertension.
Citation：
WU Bi,SONG Bin,CHEN Weixia. Collateral Venous Pathways in Pancreatogenic Splenic Vein Occlusion： Spiral CT Manifestations. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(6): 619-622. doi:
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- 2. Marn CS, Glazer GM, Williams DM, et al. CTangiographic correlation of collateral venous pathways in isolated splenic vein occlusion: new observations [Ｊ]. Radiology, 1990; 175(2)∶375.
- 3. 严志汉, 周翔平, 宋彬, 等. 胰源性门静脉系节段性阻塞的螺旋CT表现 [Ｊ]. 临床放射学杂志, 2000; 19(7)∶427.
- 4. 宋彬, 徐隽, 闵鹏秋. 胰腺的血管系统 [Ｊ]. 中国医学计算机成像杂志, 2002; 8（4）∶217.
- 5. 黄志强. 现代腹部外科学 [M]. 长沙： 湖南科学技术出版社, 1994∶365～370.
- 6. Moody AY, Poon PR. Gastroepiploic veins: CT appearance in pancreatic disease[Ｊ]. AJR, 1991; 158(4)∶779.
- 7. Song B, Min PQ, Oudkerk M, et al. Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of collateral vessels [Ｊ]. Abdominal Imaging, 2002; 25(4)∶385.
- 8. 许崇永, 周翔平, 邓开鸿, 等. 门静脉高压侧支循环CT表现 [Ｊ]. 临床放射学杂志, 1999; 18(5)∶280.
- 9. Hommeyer S, Freeny P, Crabo L， et al. Carcinoma of the head of the pancreas: evaluation of the pancreaticoduodenal veins with dynamic CTpotential for improved accuracy in staging [Ｊ]. Radiology, 1995; 196(1)∶233.
