Surgical production of splenorenal shunts in the treatment of portal hypertension has stimulated interest in the dynamics of liver blood flow. The objective of such shunts is to eliminate bleeding from esophageal varices, presumbably by reducing portal vein pressure. The reduction in portal vein pressure achieved by such a shunt can be measured by direct manometric reading at the time of surgery. However, such data are of limited value. The measurements can be obtained only at the time of operation; they vary with the systemic blood pressure, and they are frequently not reproducible in closely adjacent areas of the same vein.
It would seem desirable, then, to have some additional measure of hepatic hemodynamics. Bradley and co-workers* have estimated the liver blood flow by sulfobromophthalein (BSP) clearance. They found a reduction in the hepatic blood flow of cirrhotics, which was further reduced after a portacaval shunt.
Dobson and Jones4
NARDI GL. Effect of Splenorenal Shunts on Estimated Hepatic Blood Flow: Measurement by Radioactive Colloid. AMA Arch Surg. 1955;70(4):530–534. doi:10.1001/archsurg.1955.01270100056009
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.