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SPONTANEOUS CLOSURE OF THE PORTACAVAL ANASTOMOSIS IN THE EXPERIMENTAL ANIMAL

THOMAS C. DOUGLASS, M.D.; W. HARRISON MEHN, M.D.
AMA Arch Surg. 1950;61(4):661-666. doi:10.1001/archsurg.1950.01250020667006.
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THERE has been an interest in venous fistulas since 1877, when Eck1 first suggested a technic for producing a portacaval anastomosis. Since that time many studies of the physiologic changes produced in animals by an Eck fistula have been reported.

Blalock,2 Blakemore3 and Whipple4 have reported that a side to side portacaval fistula without obstruction of the portal vein will close, but to date no specific report of experimental work has been found in the literature. A similar fistula will remain patent in the typical animal with an Eck fistula, in which the portal vein is occluded.5

A few clinical cases have been reported in which there were recurrent gastrointestinal hemorrhages after the establishment of a portacaval fistula. It seems possible that this may be due to closure of the fistula in some instances. Many factors contribute to the maintenance of the patency of a

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