Learning objectives
Identify the presence of collateral circulation based on normal gastrointestinal tract vascular anatomy.
Review how and where most collateral vessels form on abdominal CT scans.
Understand the basic principles behind collaterals formation.
Use the knowledge of abnormal vessels anatomy to help in the diagnosis-making process of vascular and non-vascular diseases.
Background
Evaluation of the gastrointestinal vascular anatomy is a fundamental part of systematic abdominal CT examinations reading process; however vessels are not given much attention when the scan is performed for a non-vascular hypothesis with a non-angiographic protocol.
Meanwhile,
routine vascular evaluation might help the radiologist to make the diagnosis and give helpful information to orient possible treatments.
Identification and comprehension of collateral vessels networks are especially helpful as they can be the leading point on a pathway to the diagnosis of several diseases from many...
Findings and procedure details
We retrospectively reviewed cases from our institution to illustrate common patterns of collateral circulation and demonstrate how they relate to the background pathology.
The purpose of this presentation is to illustrate some patterns of gastrointestinal collateral vessels and show their correlation with basic vascular anatomy.
TABLE OF CONTENTS
Normal GI tract vascular anatomy
- Arterial
- Venous
- Concept of communicating vessels
- Arterial Circulation
- Venous Circulation
Understanding the formation of collaterals
- General principles
- Arterial
- Venous
Abnormal and collateral vessels pattern...
Conclusion
When present,
evaluation of collateral circulation is a fundamental of part of the diagnosis-making process.
Take-home messages:
Collaterals usually arise from already existing communicating vessels in the GI tract and abdomen.
The pattern of collaterals are more related to the relative "point of obstruction" than to the background pathology,
butcharacteristic patterns occur and should be recognized.
Using this anatomical knowledge can help the radiologist to locate and better understand thepathological process.
References
Sharma M,
Ramesh Babu CS Collateral Pathways in Portal Hypertension J Clin Exp Hepatol.
2012 Dec; 2(4): 338–352.
Ramesh Babu CS,Sharma MBiliary tract anatomy and its relationship with venous drainage J Clin Exp Hepatol.2014 ;4:S18-26.
Rosenblum JD,Boyle CM,Schwartz LB.The mesenteric circulation.
Anatomy and physiology.
Surg Clin North Am.1997 Apr;77(2):289-306.