Splenoportography in idiopathic splenomegaly (so-called Banti's syndrome).

Abstract

Splenoportography obtained from 71 patients with idiopathic splenomegaly (so-called Banti's syndrome) was examined in relation to the portal pressure and the extent of extrahepatic shunt. It was noted that in patients with increased portal pressure, collateral channels were visualized; the splenic vein was curved or tortuous; the sum of the length of the splenie vein and that of the portal trunk was increased; the junction of the splenic vein with the portal vein was shifted to the right; and visualization of intrahepatic branches of the portal vein was impaired. It is therefore possible from the findings in splenoportography to estimate the degree of portal hypertension. Hepatofugal collateral channels consisted most often of ascending channels through the both right and left gastric veins and the esophageal vein. In the majority of patients in whom ascending collateral channels were demonstrated in splenoportography, esophageal varices were detected in x-ray films with barium meal. Extrahepatic shunt measured with RISA was correlated well with the extent of collateral channels in splenoportography and proved to be useful in quantitative evaluation of collateral circulation.