The coeliac axis and its branches in splenomegaly and liver disease.

The anatomy of the coeliac axis and superior mesenteric artery was carefully defined by dissection (Michels, 1955) but this knowledge assumed major importance with the advent of selective catheterization for visualizing in detail the liver, spleen, and pancreas (Odman, 1956 and 1958). Since these initial studies selective arteriography has become a well recognized diagnostic procedure in pancreatic disease (Lunderquist, 1965), hepatic tumours (Stulberg and Bierman, 1965; Kreel, 1968), in demonstrating the portal vein (Boijsen), Ekman, and Olin, 1963; Kreel and Williams, 1964), and in various splenic conditions (Rosch, 1966). The radiological signs in these various conditions have been summarized in a comprehensive study based on more than 900 cases by Sammons, Neal, Armstrong, and Hager (1967). The value of hepatic arteriography has also been shown in the recognition of characteristic arterial patterns in cirrhosis (Acker, Galambos, and Weens, 1964). There has, however, been little attempt at exact correlation of the comparative sizes of the coeliac axis and splenic and hepatic arteries in relation to the size of the spleen in these diseases. In this paper we present such an analysis in a series of 161 selective coeliac arteriograms. The relationship between the changes in vascular size and splenic blood flow in a selected group is also described.