الفهرس 
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Abstract
subject of th s thesis was the study of vascular
changes, venous and art rial, that may be encolUltered in
sections of the liver cases of periportal. bilharzial
hepatic fibrosis •
For that purpose, tissue b~ocks were obtained from 37
autopsy cases that show d evidence of bilharzial hepatic
fibrosis; along with t sue blocks from six apparently
normal livers that wer used as control material •
Clinical data as well as autopsy findings were used
to identify Cfrses show ng evidence of portal hypertension.
Tissue blocks we e routinely processed , paraffin
embedded, sectioned stained with H & E, Masson Trichrome
and Orcein sta •
Microscopic ation aimed at identifying all
pathological lesions; hat were classified as follows :
lesions of small port veins and those of large one •
For that purpose, the accompanying hepatic arterial
branches were measured us~g calibrated eye piece •
Accordingly,
identified, namely S
patterns of hepatic lesions were
.er’s fibrosis ( coarse periportal
fibrosis ) in which the esions involve both small and
large portal triads; and non-Symmer’ s ( fine bilharzia1
periportal fibrosis ) c aracterized by predominant
involvement of small po al triads and notably sparing
large one •
3
the va.scular lesions encountered
ilharzial granuloma ), phleb1 tis ,
patic thrombophlebitis, arterie.1isation
and angiomatoid While in non-Symmer’s cases
pseudotubercle ( bilhar ial granuloma ), phlebitis ami
phlebosclerosis ,were t e venous lesions observed.
In Symmer’s cases
were pseudotubercles (
Correla.tion of p hological vascular venous lesions
with available infonna ion of portal hypertension reveal.ed
the following : es of portal hypertension were
associated with characteristic ot Symmer’s fibrosis
only ; (2) gory, some of lesions were attributed
to the primary disease only such as : (a) Intravascular
granuloma ( pseudotube cle ); (b) phlebitis; (c) phlebosclerosis;
(d) thrombohlebitis and (e) angiomatoid ,
whereas arterialisatio was believed to be directly related
to the effect of port hypertension on venous wall
structure •
Arterial changes ”ncluding elasto-fibrosis of
intima with reduplicat”on of internal elastic lamina,
medial hypertrophy and adventitial fibrosis were found
also in association wi mentioned venous lesions
in Symmer’s cases.
M4
Morphometric stu Y of hepatic arterial branches in
S~ner’s cases reveale significant luminal dilatation of
arterioles less than I 0 urn, while small arteries between
200 and 300 um showed ignificant luminal narrowing •
The significance of these arterial lesions was
thought to be a reflection to arterial hypertension in
hepatic circulation t at may be related to increased
arterial hepatic blo flow or sinusoidal hypertension
or both 0