Histological features of the structure of the portal vein of the liver and splenic vein in portal hypertension

Abstract

BACKGROUND: Studies on the morphological and hemodynamic changes in the structure of the portal vein of the liver and the splenic vein in various pathologies, one of which is portal hypertension, remains relevant.

AIM: To perform a histological study on the structure and thickness of the membranes of the portal vein of the liver and splenic vein in people of different age groups with normal conditions and with portal hypertension.

MATERIALS AND METHODS: Sectional material for the study of the portal vein of the liver and splenic vein was obtained from 89 people aged 7–30 years old who died from injuries incompatible with life. A total of 57 cases had a history of portal hypertension during life, and the remaining 32 cases were considered as controls. The cellular and tissue components of the vein walls were studied in paraffin sections stained with hematoxylin–eosin and Van Gieson’s stain (picric acid and fuchsin) using Weigert’s hematoxylin.

RESULTS: The thicknesses of the inner and middle membranes of venous vessels significantly increased in all age groups with portal hypertension relative to those in the control. The pathological features of changes in the thickness and microstructure of the components of the portal vein wall of the liver and splenic vein in topographically different parts of the veins were observed.

CONCLUSION: The histological and morphometric examination of the wall of the portal vein of the liver and the splenic vein in normal cases and cases of portal hypertension syndrome in different age periods revealed not only the structural features of the portal vein of the liver and splenic vein, but also the features of age-related pathomorphological changes in the individual parts of the veins and in each of the membranes. Such features are of considerable interest for clinical medicine.

Keywords

portal vein of the liver / splenic vein / portal hypertension / age-related pathological changes

References

[1] Garbuzenko DV. The mechanisms of adaptation of the vascular bed to hemodynamic changes in portal hypertension. Annals of the Russian Academy of Medical Sciences. 2013;68(1):52–57. (In Russ). doi: 10.15690/vramn.v68i1.538

[2] Гарбузенко Д.В. Механизмы адаптации сосудистого русла к гемодинамическим нарушениям при портальной гипертензии // Вестник Российской академии медицинских наук. 2013. Т. 68, № 1. С. 52–57. doi: 10.15690/vramn.v68i1.538

[3] Bulatova IA, Shchekotova AP, Tretyakova YuI. Endothelial dysfunction in chronicdiffuse liver diseases. Kazanskiy meditsinskiy zhurnal. 2009;90(1):46–48. (In Russ).

[4] Булатова И.А., Щекотова А.П., Третьякова Ю.И. Дисфункция эндотелия при хронических диффузных заболеваниях печени // Казанский медицинский журнал. 2009. Т. 90, № 1. С. 46–48.

[5] Volynets GV, Evlyukhina NN, Filin AV, et al. The relationship of the degree of impairment of the structure and function of the liver with its chronic illnesses in children. Journal of Anatomy and Histopathology. 2015;70(2):203–213. (In Russ). doi: 10.15690/vramn.v70i2.1314

[6] Волынец Г.В., Евлюхина Н.Н., Филин А.В., и др. Структура и функция печени и их нарушения при хронических болезнях гепатобилиарной системы у детей // Вестник Российской академии медицинских наук. 2015. Т. 70, № 2. С. 203–213. doi: 10.15690/vramn.v70i2.1314

[7] Getman NV. Age-related histo-topography of portal vein is normal individuals and during portal hypertension. Kuban Scientific Medical Bulletin. 2016;3:39–43. (In Russ).

[8] Гетман Н.В. Возрастная гистотопография портальной вены в норме и при портальной гипертензии // Кубанcкий научный медицинский вестник. 2016. № 3. С. 39–43.

[9] Fandeev EE, Lyubivyy ED, Goncalves GD, et al. Extrahepatic portal hypertension and portal vein thrombosis (review). Annals of HPB Surgery. 2015;20(1):45–58. (In Russ).

[10] Фандеев Е.Е., Любивый Е.Д., Гонcалвэс Г.Д., и др. Внепеченочная портальная гипертензия и тромбоз воротной вены (обзор литературы) // Анналы хирургической гепатологии. 2015. Т. 20, № 1. С. 45–58. doi: 10.16931/1995-5464.2015145-58

[11] Belik OV, Katerenyuk IM, Spinej L. Age and gender specific peculiarities of the lienal artery divisions in the hilum of the organ. Journal of Anatomy and Histopathology. 2015;4(3):26–27. (In Russ). doi: 10.18499/2225-7357-2015-4-3-26-27

[12] Белик О.В., Катеренюк И.М., Спиней Л. Варианты ветвления селезёночной артерии в области ворот органа в возрастном и половом аспектах // Журнал анатомии и гистопатологии. 2015. Т. 4, № 3. С. 26–27. doi: 10.18499/2225-7357-2015-4-3-26-27

[13] Anisimov AYu. Improvement of the diagnosis and surgical treatment of patients with portal hypertension. Annals of HPB Surgery. 2015;20(2):59–65. (In Russ). doi: 10.16931/1995-5464.2015259-65

[14] Анисимов А.Ю. Совершенствование диагностики и хирургического лечения больных портальной гипертензией // Анналы хирургической гепатологии. 2015. Т. 20, № 2. С. 59–65. doi: 10.16931/1995-5464.2015259-65

[15] Tsai MH. Splanchnic and systemic vasodilatation: the patient. J Clin Gastroenterol. 2007;41(Suppl 3):266–271. doi: 10.1097/MCG.0b013e3181576d1a

[16] Tsai M.H. Splanchnic and systemic vasodilatation: the patient // J Clin Gastroenterol. 2007. Vol. 41, Suppl. 3. P. 266–271. doi: 10.1097/MCG.0b013e3181576d1a

[17] Wen B, Liang J, Deng X, et al. Effect of fluid shear stress on portal vein remodeling in a rat model of portal hypertension. Gastroenterol Res Pract. 2015;2015:545018. doi:10.1155/2015/545018

[18] Wen B., Liang J., Deng X., et al. Effect of fluid shear stress on portal vein remodeling in a rat model of portal hypertension // Gastroenterol Res Pract. 2015, N 2015. Р. 545018. doi: 10.1155/2015/545018

[19] Iwakiri Y. Pathophysiology of portal hypertension. Clin Liver Dis. 2014;18(2):281–291. doi: 10.1016/j.cld.2013.12.001

[20] Iwakiri Y. Pathophysiology of portal hypertension // Clin Liver Dis. 2014. Vol. 18, N 2. Р. 281–291. doi: 10.1016/j.cld.2013.12.001

[21] Abdurahmanov BA. Rentgenoendovaskulyarnaya khirurgiya v korrektsii portalnoy gipertenzii u bolnykh tsirrozom pecheni. Palliative Medicine and Rehabilitation. 2013;4:34–39. (In Russ).

[22] Абдурахманов Б.А. Рентгеноэндоваскулярная хирургия в коррекции портальной гипертензии у больных циррозом печени // Паллиативная медицина и реабилитация. 2013. № 4. С. 34–39.

[23] Kim MY, Baik SK, Lee SS. Hemodynamic alterations in cirrhosis and portal hypertension. Korean J Hepatol. 2010;16(4):347–352. doi: 10.3350/kjhep.2010.16.4.347

[24] Kim M.Y., Baik S.K., Lee S.S. Hemodynamic alterations in cirrhosis and portal hypertension // Korean J Hepatol. 2010. Vol. 16, № 4. P. 347–352. doi: 10.3350/kjhep.2010.16.4.347

[25] Michiels C, Bouaziz N, Remacle J. Role of the endothelium and blood stasis in the development of varicose veins. Int Angiol. 2002;21(2 Suppl 1):18–25.

[26] Michiels C., Bouaziz N., Remacle J. Role of the endothelium and blood stasis in the development of varicose veins // Int Angiol. 2002. Vol. 21, № 2, Suppl. 1. P. 18–25.

[27] Strakhov SN, Bosin VYu, Bondar ZM, Kosyreva NB. Angiological characteristics of pathological changes in the portal vein of children with extrahepatic portal hypertension. Russian Bulletin of Perinatology and Pediatrics. 2013;58(1):80–84. (In Russ).

[28] Страхов С.Н., Босин В.Ю., Бондар З.М., Косырева Н.Б. Ангиологическая характеристика патологических изменений воротной вены при внепечёночной портальной гипертензии у детей // Российский вестник перинатологии и педиатрии. 2013. Т. 58, № 1. С. 80–84.

[29] Garbuzenko DV. Morphofunctional rearrangement of the hepatic vasculature in the pathogenesis of portal hypertension in liver cirrhosis. Terapevticheskij arhiv. 2014;2:90–95. (In Russ).

[30] Гарбузенко Д.В. Морфофункциональная перестройка печёночного сосудистого русла в патогенезе портальной гипертензии при циррозе печени // Терапевтический архив. 2014. Т. 86, № 2. С. 90–95.

[31] Biecker E. Portal hypertension and gastrointestinal bleeding: diagnosis, prevention and management. World J Gastroenterol. 2013;19(31):5035–5050. doi: 10.3748/wjg.v19.i31.5035

[32] Biecker E. Portal hypertension and gastrointestinal bleeding: diagnosis, prevention and management // World J Gastroenterol. 2013. Vol. 19, N 31. P. 5035–5050. doi: 10.3748/wjg.v19.i31.5035

[33] Zhang H, Li B. Pathological changes and iNOS expression in portal vein and hepatic artery of patients with liver cirrhosis and portal hypertension. Int J Clin Exp Pathol. 2016 June [cited 20 Dec 2018;9(12):12188–12196. Available from: https://e-century.us/files/ijcep/9/12/ijcep0033987.pdf.

[34] Zhang H., Li B. Pathological changes and iNOS expression in portal vein and hepatic artery of patients with liver cirrhosis and portal hypertension // Int J Clin Exp Pathol. 2016. Vol. 9, N 12. Р. 12188–12196. Режим доступа: https://e-century.us/files/ijcep/9/12/ijcep0033987.pdf. Дата обращения: 20.12.2018.

[35] Stamm ER, Meier JM, Pokharel SS, et al. Normal main portal vein diameter measured on CT is larger than the widely referenced upper limit of 13 mm. Abdom Radiol (NY). 2016;41(10):1931–1936. doi: 10.1007/s00261-016-0785-9

[36] Stamm E.R., Meier J.M., Pokharel S.S., et al. Normal main portal vein diameter measured on CT is larger than the widely referenced upper limit of 13 mm // Abdom Radiol (NY). 2016. Vol. 41, N 10. P. 1931–1936. doi: 10.1007/s00261-016-0785-9

[37] Somers P, Knaapen M. The histopathology of varicose vein disease. Angiology. 2006;57(5):546–555. doi: 10.1177/0003319706293115

[38] Somers P., Knaapen M. The histopathology of varicose vein disease // Angiology. 2006. Vol. 57, № 5. P. 546–555. doi: 10.1177/0003319706293115

[39] Stein JH, Tattersall MC. Carotid intima-media thickness and cardiovascular disease risk prediction. J Am Coll Cardiol. 2014;63(21):2301–2302. doi: 10.1016/j.jacc.2014.02.528

[40] Stein J.H., Tattersall M.C. Carotid intima-media thickness and cardiovascular disease risk prediction // J Am Coll Cardiol. 2014. Vol. 63, N 21. P. 2301–2302. doi: 10.1016/j.jacc.2014.02.528

[41] Rodriguez-Diaz E, Baffy G, Singh SK. Probe-based confocal laser endomicroscopy quantitative morphometric markers associated with portal hypertension in duodenal mucosa. Liver Int. 2016;36(2):223–231. doi: 10.1111/liv.12906

[42] Rodriguez-Diaz E., Baffy G., Singh S.K. Probe-based confocal laser endomicroscopy quantitative morphometric markers associated with portal hypertension in duodenal mucosa // Liver Int. 2016. Vol. 36, N 2. P. 223–231. doi: 10.1111/liv.12906

[43] Volynets GV, Evlyukhina NN, Filin AV, et al. Determining the degree of disruption of the structure of the liver and the severity of portal hypertension in children. Eksp Klin Gastroenterol. 2015;(1):28–35. (In Russ).

[44] Волынец Г.В., Евлюхина Н.Н., Филин А.В., и др. Определение степени нарушения структуры печени и выраженности портальной гипертензии у детей // Экспериментальная и клиническая гастроэнтерология. 2015. № 1. С. 28–35.

[45] Roussis PC, Giannakopoulos AE, Charalambous HP. Suture line response of end-to-side anastomosis: a stress concentration methodology. Cardiovasc Eng Technol. 2015;6(1):36–48. doi: 10.1007/s13239-014-0206-6

[46] Roussis P.C., Giannakopoulos A.E., Charalambous H.P. Suture line response of end-to-side anastomosis: a stress concentration methodology // Cardiovasc Eng Technol. 2015. Vol. 6, N 1. P. 36–48. doi: 10.1007/s13239-014-0206-6

[47] Rosmorduc O. Antiangiogenic therapies in portal hypertension: a breakthrough in hepatology. Gastroenterol Clin Biol. 2010;34(8–9):446–449. doi: 10.1016/j.gcb.2010.05.007

[48] Rosmorduc O. Antiangiogenic therapies in portal hypertension: a breakthrough in hepatology // Gastroenterol Clin Biol. 2010. Vol. 34, N 8–9. Р. 446–449. doi: 10.1016/j.gcb.2010.05.007

[49] Zeng J, Yang Z, Xu J. Extrahepatic vascular smooth muscle cell apoptosis and apoptosis-related-gene expression in patients with portal hypertension. Chin J Exp Surg. 2003;(8):749–750.

[50] Zeng J., Yang Z., Xu J. Extrahepatic vascular smooth muscle cell apoptosis and apoptosis-related-gene expression in patients with portal hypertension // Chin J Exp Surg. 2003. N 8. P. 749–750.

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