Decreased arteriovenous flow resistance in the left gastric venous area in cirrhotic patients

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Abstract
To assess the relationship between the fluid mechanics in the left gastric venous area and the portal trunk, manometric measurements were made in patients with or without cirrhosis of the liver. In 10 normal subjects, temporary portal vein occlusion produced comparable elevation in both the occluded left gastric venous pressure (OLGP) and the portal vein pressure (PVP): 152-429 mm of water in OLGP and 115-452 mm of water in PVP. In 60 cirrhotic patients with portal hypertension, the portal vein occlusion resulted in far less increase in OLGP than that in PVP: 281-365 mm of water in OLGP and 281-540 mm of water in PVP. Regarding pressure measurements, the relationship was separated in cirrhotics, but continuous in normal subjects. Mathematical analysis of the data using a modification of Wheatstone bridge model suggested that the arteriovenous flow resistance in the left gastric venous area of cirrhotics was reduced to < 1/5 of that in the controls. The increased flow capacity as a result of a reduced arteriovenous flow resistance apparently is responsible for the functional separation from the portal trunk.