Skip to main content

Gastrointestinal Vascular Physiology

  • Chapter
Pan Vascular Medicine

Abstract

The splanchnic circulation comprises the arterial blood supply and venous drainage of the entire gastrointestinal tract from the distal esophagus to the mid rectum, including the spleen, pancreas, gallbladder, and liver. As described in detail in the previous chapter, this arterial system is derived from the celiac plexus as well as the superior and inferior mesenteric arteries. These arterial routes, with the exception of the hepatic artery, eventually empty into the portal venous system via the splenic vein, and superior and inferior mesenteric veins. The portal vein, which constitutes the primary blood supply to the liver, is formed by the convergence of the splenic and superior mesenteric vein. After perfusing the liver, venous blood re-enters the systemic circulation through the hepatic veins and the suprahepatic inferior vena cava.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Shah V, Garcia-Gardena G, Sessa WC, Groszmann RJ (1998) The hepatic circulation in health and disease: report of a single-topic symposium. Hepatology 27:279–288

    Article  CAS  PubMed  Google Scholar 

  2. McCuskey RS, Reilly FD (1993) Hepatic microvasculature: dynamic structure and its regulation. Semin Liver Dis 13:1–11

    Article  CAS  PubMed  Google Scholar 

  3. Pinzani M, Failli P, Ruocco C, Casini A, Milani S, Baldi E, Giotti A, Gentilini P (1992) Fat-storing cells as liver-specific pericytes. Spatial dynamics of agonist-stimulated intracellular calcium transients. J Clin Invest 90:642–646

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Rockey DC, Weisiger RA (1996) Endothelin-inducted contractility of stellate cells from normal and cirrhotic rat liver: implications for regulation of portal pressure and resistance. Hepatology 24:233–240

    Article  CAS  PubMed  Google Scholar 

  5. Zhang J, Pegoli W, Clemens M (1994) Endothelin-1 induces direct constriction of hepatic sinusoids. Am J Physiol 266:G624–G632

    Google Scholar 

  6. Clemens M (1999) Nitric oxide in liver injury. Hepatology 30:1–4

    Article  CAS  PubMed  Google Scholar 

  7. Shah V et al (1997) Liver sinusoidal endothelial cells are responsible for nitric oxide modulation of hepatic resistance. J Clin Invest 100: 2923–2930

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Shah VH, Chen AF, Cao S, Hendrickson HI, Weiler D, Smith LA, Yao J, Katusic ZS (2001) Gene transfer of recombinant endothelial nitric oxide synthase to liver in vivo and in vitro. Am J Physiol Gastrointest Liver Physiol 279:G1023–1030

    Google Scholar 

  9. Kaneda K, Ekataksin W, Sogawa M, Matsumura A, Cho A, Kawada N (1998) Endothelin-1-induced vasoconstriction causes a significant increase in portal pressure of rat liver: localized constrictive effect on the distal segment of preterminal portal venules as revealed by light and electron microscopy and serial reconstruction. Hepatology 27:735–747

    Article  CAS  PubMed  Google Scholar 

  10. Suematsu M, Goda N, Sano T, Kashiwagi S, Egawa T, Shinoda Y, Ishimura Y (1995) Carbon monoxide: an endogenous modulator of sinusoidal tone in the perfused rat liver. J Clin Invest 96:2431–2437

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Grossman H, Grossman V, Bhathal P (1994) Intrahepatic vascular resistance in cirrhosis. In: Bosch J, Groszmann R (eds) Portal hypertension: pathophysiology and treatment. Blackwell Scientific, Oxford, pp 1–16

    Google Scholar 

  12. Rappaport A, Schneiderman J (1976) The function of the hepatic artery. Rev Physiol Biochem Pharmacol 76:129–175

    Article  CAS  PubMed  Google Scholar 

  13. Ekataksin W (2000) The isolated artery: an intrahepatic arterial pathway that can bypass the lobular parenchyma in mammalian livers. Hepatology 31:269–279

    Article  CAS  PubMed  Google Scholar 

  14. Lautt WW (1983) Relationship between hepatic blood flow and overall metabolism: the hepatic arterial buffer response. Fed Proc 42: 1662–1666

    CAS  PubMed  Google Scholar 

  15. Lautt WW (1996) The 1995 Ciba-Geigy Award Lecture. Intrinsic regulation of hepatic blood flow. Can J Pharmacol 74:223–233

    Article  CAS  Google Scholar 

  16. Fara J (1984) Postprandial mesenteric hyperemia. In: Shepherd A, Granger D (eds) Physiology of the intestinal circulation. Raven, New York, p 99

    Google Scholar 

  17. Chou CC, Kvietys P, Post J, Sit P (1978) Constituents of chyme responsible for postprandial intestinal hyperemia. Am J Physiol 235:H677

    Google Scholar 

  18. Granger DN, Richardson PD, Kvietys PR, Mortillaro NA (1980) Intestinal blood flow. Gastroenterology 78:837–863

    CAS  PubMed  Google Scholar 

  19. Crissinger K, Granger D (1995) Gastrointestinal blood flow. In: Yamada T (ed) Textbook of gastroenterology. Lippincott, Philadelphia, pp 518–545

    Google Scholar 

  20. Ito S, Ohga A, Ohta T (1988) Gastric vasodilatation and vasoactive intestinal peptide output in response to vagal stimulation in the dog. J Physiol (Lond) 404:669

    CAS  Google Scholar 

  21. Coupar I, McLennan P (1978) The influence of prostaglandins on no-radrenaline-induced vasoconstriction in isolated perfused mesenteric blood vessels of the rat. Br J Pharmacol 62:51–59

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Kusayama T, Yamazaki J, Nagao T (1996) Flow dependence of nitric oxide-mediated pressure change in rat mesenteric beds with different tonus. Eur J Pharmacol 312:301–307

    Article  CAS  PubMed  Google Scholar 

  23. Sieber C, Lopez-Talvera JC, Groszmann RJ (1993) Role of nitric oxide in the in vitro splanchnic vascular hyporeactivity in ascitic cirrhotic rats. Gastroenterology 104:1750–1754

    CAS  PubMed  Google Scholar 

  24. Groszmann R, Atterbury C (1982) The pathophysiology of portal hypertension: a basis for classification. Semin Liver Dis 2:177–186

    Article  CAS  PubMed  Google Scholar 

  25. Patch D, Armonis A, Sabin C, Christopoulou K, Greenslade L, McCormick A, Dick R, Burroughs AK (1999) Single portal pressure measurement predicts survival in cirrhotic patients with recent bleeding. Gut 44:264–269

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Boyer T, Triger DR, Horisawa M, Redeker AG, Reynolds TB (1977) Direct transhepatic measurement of portal vein pressure using a thin needle. Comparison with wedged hepatic vein pressure. Gastroenterology 72:584–589

    CAS  PubMed  Google Scholar 

  27. Panke W, Bradley EG, Moreno AH, Ruzicka FF, Rousselot LM (1959) Techniques, hazards and usefulness of percutaneous splenic portography. JAMA 169:1032–1037

    Article  CAS  Google Scholar 

  28. Parvey H, Eisenberg RL, Giyanani V, Krebs CA (1989) Duplex sonography of the portal venous system: pitfalls and limitations. Am J Roentgenol 152:765–770

    Article  CAS  Google Scholar 

  29. Dalman R, Li KC, Moon WK, Chen I, Zarins CK (1996) Diminished postprandial hyperemia in patients with aortic and mesenteric arterial occlusive disease. Quantification by magnetic resonance flow imaging. Circulation 94:II206–II210

    Google Scholar 

  30. Goresky C (1963) A linear method for determining liver sinusoidal and extravascular volumes. Am J Physiol 204:626–640

    CAS  PubMed  Google Scholar 

  31. Huet PM, Goresky CA, Villeneuve JP, Marleau D, Lough JO (1982) Assessment of liver microcirculation in human cirrhosis. J Clin Invest 70:1234–1244

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Bosch J, Groszmann R (1984) Measurement of azygous venous blood flow by a continuous thermodilution technique: an index of blood flow through gastroesophageal collaterals in cirrhosis. Hepatology 4:424

    Article  CAS  PubMed  Google Scholar 

  33. Jackson F, Adrian AL, Black M, Miller LS (1999) Calculation of esophageal variceal wall tension by direct sonographic and manometric measurements. Gastrointest Endosc 50:247–251

    Article  CAS  PubMed  Google Scholar 

  34. Parks DA, Skinner KA, Gelman S, Maze E (2000) Hepatic physiology. In: Miller RD (ed) Anesthesia, 5th edn. Churchill Livingstone, Philadelphia, pp 647–661

    Google Scholar 

  35. Johnson EE, Hedley-Whyte J (1975) Continuing positive pressure ventilation and choledochoduodenal flow resistance. J Appl Physiol 39:937–945

    CAS  PubMed  Google Scholar 

  36. Cooperman LH, Warden JC, Price HL (1968) Splanchnic circulation during nitrous oxide anesthesia and hypocarbia in normal man. Anesthesiology 29:254–258

    Article  CAS  PubMed  Google Scholar 

  37. Gelman S (1987) General anesthesia in hepatic circulation. Can J Physiol Pharmacol 252:1762–1766

    Article  Google Scholar 

  38. Gelman S, Fowler KC, Smith LR (1984) Liver circulation and function during isoflurane and halothane anesthesia. Anesthesiology 61: 726–734

    Article  CAS  PubMed  Google Scholar 

  39. Kennedy WF, Everett GB, Cobb LA (1970) Simultaneous systemic and hepatic hemodynamic measurements during high spinal anesthesia in normal man. Anesth Anesthesiol 49:1016–1023

    Google Scholar 

  40. Nagano K, Gelman S, Parks DA (1990) Hepatic oxygen supply — uptake relationship and metabolism during anesthesia in miniature pigs. Anesthesiology 72:902–910

    Article  CAS  PubMed  Google Scholar 

  41. Rockey D (1997) The cellular pathogenesis of portal hypertension: stellate cell contractility, endothelin, and nitric oxide. Hepatology 25:1–5

    Article  Google Scholar 

  42. Baldus WP, Hoffbauer FW (1963) Vascular changes in the cirrhotic liver as studied by injection technique. Am J Dig Dis 8:689–692

    Article  CAS  PubMed  Google Scholar 

  43. Bhathal PS, Grossman AJ (1985) Reduction of the increased portal vascular resistance of the isolated profuse cirrhotic liver by vasodilators. J Hepat 1:325–337

    Article  CAS  Google Scholar 

  44. Pinzani MS, Milani S, DeFranco R, Cirappone C, Caliguri A, Gentilini A, Tosti-Guerra C, Maggi M, Failli P, Ruocco C, Gentilini P (1996) Endothelin-1 is over-expressed in human cirrhotic liver and exerts multiple effects on activated hepatic stellate cells. Gastroenterology 110:534–548

    Article  CAS  PubMed  Google Scholar 

  45. Asbert MA, Gines A, Gines P, Jimenez W, Claria J, Salo J, et al (1993) Circulatory levels of endothelin in cirrhosis. Gastroenterology 104:1485–1491

    CAS  PubMed  Google Scholar 

  46. Gerbes AL, Moller S, Gulberg V, Henriksen JH (1995) Endothelin-1 and -3 plasma concentrations in patients with cirrhosis: role of splanchnic and renal passage and liver function. Hepatology 21:735–739

    CAS  PubMed  Google Scholar 

  47. Moore K, Wendon J, Frazer M, Karani J, Williams R, Badr K (1992) Plasma endothelin immunoreactivity in liver disease and the hepatorenal syndrome. N Engl J Med 327:1774–1778

    Article  CAS  PubMed  Google Scholar 

  48. Housset CN, Rockey DC, Bissel DM (1993) Endothelin receptors in rat liver: lipocytes as a contractile target for endothelin-1. Proc Natl Acad Sci U S A 90:9266–9270

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  49. Kamath PS, Tyce GM, Miller VM, Edwards BS, Rorie DK (1999) Endothelin-1 modulates intrahepatic resistance in a rat model of noncirrhotic portal hypertension. Hepatology 30:401–407

    Article  CAS  PubMed  Google Scholar 

  50. Kamath PS, Carpenter HC, Edwards BS, Miller VM, McKusick MA, Steers JL (1996) Elevated endothelin-1 in portal hypertension as a result of increased hepatic production. Gastroenterology no:A1227

    Google Scholar 

  51. Bauer M, Zhang JX, Bauer I, Clemens MG (1994) ET-1-induced alterations of hepatic microcirculation: sinusoidal and extrasinusoidal sites of action. Am J Physiol 267:G143–G149

    Google Scholar 

  52. Kaneda K, Ekataksin W, Sogawa M, Matsumara A, Cho A, Kawada N (1998) Endothelin-1-induced vasoconstriction causes a significant increase in portal pressure of rat liver: localized constrictive effect on the distal segment of preterminal portal venules as revealed by light and electron microscopy and serial reconstruction. Hepatology 27:5–47

    Article  Google Scholar 

  53. Oshito M, Takei Y, Kawano S, Yoshihara H, Hijiota T, Fukui H, Goto M, Masuda M, Nishimura Y, Fusamoto H, Kamada T (1993) Roles of endothelin-1 and nitric oxide in the mechanism for ethanol-induced vasoconstriction in rat liver. J Clin Invest 91:137–142

    Google Scholar 

  54. Rockey DC, Chung JJ (1998) Reduced nitric oxide production by endothelial cells in cirrhotic rat liver: endothelial dysfunction in portal hypertension. Gastroenterology 114:344–351

    Article  CAS  PubMed  Google Scholar 

  55. Gupta T, Toruner M, Chung MK, Groszmann RJ (1998) Endothelial dysfunction and decreased production of nitric oxide in the intrahepatic microcirculation of cirrhotic rats. Hepatology 28:926–931

    Article  CAS  PubMed  Google Scholar 

  56. Shah V, Toruner M, Haddad F, et al (1999) Impaired endothelial nitric oxide synthase activity associated with enhanced caveolin-binding in experimental liver cirrhosis. Gastroenterology 117:1222–1228

    Article  CAS  PubMed  Google Scholar 

  57. Colombato LA, Albillos A, Groszmann RJ (1992) Temporal relationship of peripheral vasodilatation, plasma volume expansion and the hyperdynamic circulatory state in portal hypertensive rats. Hepatology 15:323–328

    Article  CAS  PubMed  Google Scholar 

  58. Groszmann RJ (1994) Hyperdynamic circulation of liver disease, 40 years later: pathophysiology and clinical consequences (editorial). Hepatology 20:1359–1363

    Article  CAS  PubMed  Google Scholar 

  59. Casadevall M, Panes J, Pique JM (1993) Involvement of nitric oxide and prostaglandins in gastric mucosal hyperemia or portal hypertensive anesthetized rats. Hepatology 18:628–634

    Article  CAS  PubMed  Google Scholar 

  60. Sieber CC, Groszmann RJ (1992) Nitric oxide mediates hyperreactivity to vasopressors in mesenteric vessels of portal hypertensive rats. Gastroenterology 103:235–239

    CAS  PubMed  Google Scholar 

  61. Sieber CC, Groszmann RJ (1992) In vitro hyperreactivity to methox-amine in portal hypertensive rats: reversal by nitric oxide blockade. Am J Physiol 262:G996-G1001

    Google Scholar 

  62. Polio J, Groszmann RJ (1986) Hemodynamic factors involving the development and rupture of esophageal varices: a pathophysiological approach to treatment. Semin Liver Dis 6:318–331

    Article  CAS  PubMed  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Shah, V.H., Kamath, P.S., de Groen, P.C. (2002). Gastrointestinal Vascular Physiology. In: Lanzer, P., Topol, E.J. (eds) Pan Vascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56225-9_108

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-56225-9_108

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62565-7

  • Online ISBN: 978-3-642-56225-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics