As portal hypertension progresses collateral veins become important sources of venous return.

Collateral drainage in portal hypertension include:

(1) submucosal esophageal varices

(2) paraesophageal varices

(3) submucosal gastric veins (watermelon stomach)

(4) paragastric varices

(5) caput medusae (cirsomphalos), with drainage to axillary and/or femoral veins

(6) retroperitoneal varcies

(7) dilation of the azygous vein

(8) dilation of the left renal vein

(9) paragallbladder varices

(10) anorectal varices

(11) stomal varices


As the hypertension progresses there may be a fistula between the hepatic artery and portal vein.

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