Peritoneoscopic features of intraabdominal vessels in cirrhosis of the liver.

Peritoneoscopy was carried out in 57 cirrhotic patients in order to evaluate the morphological features of intraabdominal veins. These were described either as normal or characterized by minimal, moderate, or marked alterations: accordingly, the patients were classified into four groups. Intrahepatic and intrasplenic pressures were measured in most patients; abnormally elevated values were found in every case, and the higher figures belonged to the subjects with minor involvement of the intraabdominal veins. Superficial collateralization and oesophageal varices appeared unrelated to changes in these veins, whereas splenomegaly was mostly found in patients with normal or slightly altered intraabdominal veins. Percutaneous splenoportography was performed in 16 patients, and venographic appearances did not correlate with peritoneoscopic features of the intraabdominal veins. Ascites, on the other hand, was exclusively present in patients with alterations in these veins. It is suggested that some pathogenetic relationship might exist between changes in intraabdominal veins seen by peritoneoscopy and ascites.