No abstract

Five cases representing four different venous anomalies involving the portal system are described. The clinical importance of these anomalies, especially in patients with portal hypertension, is stressed.

To evaluate its potential as an alternative to angiography in the diagnosis of pancreatic tumors, we performed selective vein catheterization for hormone assay on 11 patients with islet cell tumors and islet cell hyperplasias. In all patients, the abnormal pancreatic tissue was correctly localized preoperatively by this method.

The venous anatomy of 22 autopsy specimens of human pancreas was examined by dissection and radiography after injection of gelatin agent. The most constant findings were the posterior superior pancreaticoduodenal vein draining to the portal vein and the anterior superior pancreaticoduodenal vein draining to the gastrocolic trunk and superior mesenteric vein. Both veins were identified in 21 and 20 of 22 cases, respectively. All other pancreatic veins varied considerably in their course. The normal findings in clinical selective pancreatic phlebography based on 148 examinations are described.

Based on 45 examinations the technique of selective catheterization of the pancreatic veins for blood sampling using percutaneous transhepatic approach to the portal vein is described. The results are compared with the angiographic findings in 16 patients with islet cell tumours of islet cell hyperplasia.