IT IS GENERALLY held that the cause of portal hypertension in cases of Laennec cirrhosis is the result of diffuse fibrosis within the liver so that the intrahepatic portal veins are narrowed and compressed. Thus portal blood reaching the right heart seeks a route that bypasses the liver. One of these routes is through the coronary vein of the stomach to the veins of the esophagus and thence through the azygos system to the right side of the heart. In the esophagus the veins are poorly supported; pressure produces varices, and rupture not uncommonly results in fatal hemorrhage. Although many surgical procedures have been used in the treatment of varices of the esophagus, none has been entirely successful. Indeed, the prevention of hemorrhage from such varices remains an outstanding surgical problem.
This difficulty would be resolved if a method were found that would effect an increase in the flow of
SMITH JC, McNEALY RW, ZAUS EA. EFFECT OF HEPATIC ARTERY LIGATION ON ASCITES DUE TO LAENNEC CIRRHOSISReport of Two Cases. AMA Arch Surg. 1953;66(3):344-355. doi:10.1001/archsurg.1953.01260030359010