CARDIOVASCULAR ABNORMALITIES develop in patients with advanced chronic liver disease to produce a hyperdynamic systemic circulation with splanchnic vasodilation, decreased systemic vascular resistance, and increased cardiac output (J Hepatol.
Another series of studies have shown that through actions in rostral ventrolateral medulla (rVLM), stimulation of both gallbladder and gastric afferent activates splanchnic nerves and increases blood pressure.
However due to the creation of pneumoperitoneum, increase in intraabdominal pressure causes liver splanchnic vessels to undergo mesenteric hypoxia, ischemia-reperfusion injury and associated increase in oxidative stress [1].
In addition to hepatic parenchymal disease evaluation on grey scale imaging, the introduction of duplex doppler ultrasonography has proven to be a break-through in evaluation of splanchnic hemodynamic changes set in secondary to portal hypertension, a known insidious complication of chronic liver disease10,15, 16
The basic abnormality is a vascular aberration in which the splanchnic venous return drains directly into the systemic veins (IVC or the left renal, left iliac or left hepatic vein), diverting the mesenteric circulation away from the liver.
Although we did not observe vascular stenosis or thrombosis on contrast-enhanced CT, the patient's prior right lobectomy might have resulted in hemodynamic change from altered splanchnic venous anatomy.
All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional.