GALLBLADDER VARICES - DEMONSTRATION OF DIRECT COMMUNICATION TO INTRAHEPATIC PORTAL VEINS BY COLOR DOPPLER SONOGRAPHY AND CT DURING ARTERIALPORTOGRAPHY

Gallbladder varices were correctly diagnosed by color Doppler sonograp hy and computed tomography during arterial portography (CTAP) in two p atients with portal vein thrombosis. One patient with multiple hepatoc ellular carcinomas showed extrahepatic and intrahepatic portal vein oc clusion by a tumor thrombus. The other patient, with liver cirrhosis, had a portal vein thrombosis. Color Doppler sonography clearly showed the portal vein occlusion, cavernous transformation of collateral vein s, and gallbladder varices that drained into the intrahepatic portal v enous branches. The intrahepatic portal venous branch, connecting to t he gallbladder varices, exhibited reverse flow from the periphery to t he hilum of the liver. CTAP also demonstrated gallbladder varices comm unicating directly with the intrahepatic portal vein branches in both patients. Gallbladder varices developed as a venous collateral because of extrahepatic portal vein occlusion. Color Doppler sonography and C TAP are useful for detecting these var ices and planning biliary surge ry in patients with portal vein thrombosis.