Atherosclerosis like changes in splenic vein and gastric coronary vein of cirrhotic patients

Objective\ To investigate the atherosclerosis like changes in splenic vein and gastric coronary vein of cirrhotic patients, and their pathogenesis and clinical implication. Methods\ The esophagogastric devascularization with splenectomy were performed upon 50 cases of cirrhosis. The splenic vein and gastric coronary vein were taken during operation and studied morphologically. The 10 cases of peptic ulcer of duodenum and 10 cases of ruptured spleen due to trauma served as control group. Results\ In the cirrhotic patients, the light microscopy showed the splenic and gastric coronary vein become thicken significantly, the endotheliocytes were not intact, the papilla like or diffuse thick proliferative nodules were observed. There were a lot of smooth muscle cells with disturbed arrangement, fibro connective materials, and some atheronecrosis, broken materials in subintimal space. The smooth muscle cells in midlayer become thicken and migrated to underintima. The electron microscopy showed that broken endothelium, thrombosis to vessel wall, a lot of proliferative smooth muscle cells and collagen fibers in underintima. The phenotype of smooth muscle cells changed from contractile to synthotic type. Conclusion\ In portal hypertensive patients, the atherosclerosis like plaque was formed due to proliferation, migration and phenotypic changes of SMC, which resulted in the formation of rugged, thick and hard splenic and gastric coronary vein.\;