Pathology of fundic varices of the stomach and rupture
Pathology of fundic varices of the stomach and rupture
复制标题
DOI：
10.1046/j.1440-1746.2002.02855.x
复制
发表时间：
2002-10-01
影响因子：
4.1
通讯作者：
Okuda, K
中科院分区：
文献类型：
--
作者：
Arakawa, M;Masuzaki, T;Okuda, K
背景和目的：胃静脉曲张破裂是门静脉高压症的致命并发症，在组织病理学上还没有很好的记录。虽然心脏静脉曲张与食管静脉曲张连续发展，但胃底静脉曲张独立发展，具有特征性病理生理学。阐明胃底静脉曲张的血管结构将有利于今后的改进treatment.Methods：12胃底静脉曲张，无论是切除或尸检，检查通过注射钡明胶溶液到静脉，形成静脉曲张，软X线的血管课程的研究，然后胃制成透明的准备工作，立体研究。结果：胃底静脉曲张可分为两种类型：Ⅰ型，单支静脉构成供血血管、静脉曲张血管和引流血管，但不改变管径（8例）或多支静脉组成静脉曲张血管（1例）; Ⅱ型，在主要供血血管和引流血管旁存在多支分支血管（3例）。胃底静脉曲张存在于粘膜下层，在固有层中没有扩大的静脉，并通过静脉曲张的一部分，突出到胃腔穿透粘膜肌层和laminapropriate.Conclusions：胃底静脉曲张的形式与供应血管，大多数是单一的，和引流血管往往是胃肾侧支。与食管静脉曲张不同，胃底静脉曲张形成于粘膜下层，并穿过上覆的粘膜肌层和固有层。(C)2002 Blackwell Publishing Asia Pty Ltd.
Background and Aim: Gastric varices, the rupture of which can be a fatal complication of portal hypertension, have not been well documented histopathologically. While cardiac varices develop in continuity with esophageal varices, fundic varices develop independently, having characteristic pathophysiology. Elucidation of the angioarchitecture of fundic varices will facilitate future improvement of treatment.Methods: Twelve stomachs with fundic varices, either resected or autopsied, were examined by injecting a barium-gelatin solution into the vein that was forming varices, soft X-rayed for the study of the vessel course, and then the stomach made into transparent preparations for stereoscopic study. Five fundic varices with a recognizable rupture site were studied histologically.Results: Fundic varices could be classified into two types: Type I, single vein forming the supplying vessel, varix and draining vessel without changing caliber (eight cases) or plural veins supplying the varix (one case) and; Type II, many branching vessels existing beside the main supplying and draining vessels (three cases). Fundic varices exist in the submucosa with no enlarged vein in the lamina propria, and rupture occurs through the portion of the varix that protrudes into the stomach lumen penetrating the muscularis mucosae and lamina propria.Conclusions: Fundic varices form with the supplying vessel, mostly singular, and the draining vessel is frequently a gastrorenal collateral. Fundic varices form in the submucosa, unlike esophageal varices, and perforate through the overlying muscularis mucosae and lamina propria. (C) 2002 Blackwell Publishing Asia Pty Ltd.