Three‐dimensional view of the vascular structure of the lower esophagus in clinical portal hypertension

Makoto Hashizume, Seigo Kitano, Keizo Sugimachi, Katsuo Sueishi

Research output: Contribution to journalArticlepeer-review

118 Citations (Scopus)


The venous anatomy of the lower esophagus and upper stomach was studied in nine patients with portal hypertension and in five without, following infusion of a silicon rubber compound into vessels of the excised organs within whole tissues made transparent with methyl salicylate. Four venous channels were identified in normal tissues: intraepithelial, subepithelial superficial, deep submucosal and adventitial veins. In portal hypertensive patients, giant esophageal varices formed 2 to 3 cm above the esophagogastric junction fused with numerous superficial and deep submucosal veins. Gastric varices were present in the submucosa where the left gastric venous branch penetrated the gastric wall 2 cm below the esophagogastric junction. The lower esophageal varices were classified into two types of vascular structure: palisading type in five and bar type in four. The palisading type had dilated intraepithelial channels and numerous small superficial collateral veins extending in a longitudinal arrangement. The bar type had triply dilated subepithelial superficial veins and deep submucosal veins which eroded the epithelium, and the gastric varices were present in the latter type. Our study provides evidence of the three‐dimensional vascular structure of the lower esophageal varices without the necessity for tissue dissection.

Original languageEnglish
Pages (from-to)1482-1487
Number of pages6
Issue number6
Publication statusPublished - 1988
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology


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