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Gastric anisakiasis was an incidental finding on gastroscopy of a 48-year-old man known to have AIDS. At that time the patient had been symptom-free, the test having been performed to check on an ulcerative Candida oesophagitis. The Anisakis larva was extracted through the gastroscope and there has been no recurrence. The history suggested a chronic course. The unusual absence of symptoms suggests that the immunodeficiency had influenced the pathogenesis of the parasitic disease.

Both external and internal factors have to be thought of as causes of obliterative disease of liver veins. Pathogenetically, thrombosis or proliferative vascular disease (endophlebitis hepatica obliterans) may affect either large veins (with occlusion of the ostia) or small ones. Veno-occlusive disease, caused by pyrrolizidine derivatives, is a special form. Injection of contrast medium to the inferior vena cava and (or) the liver veins is the most important diagnostic method. In two personal cases there was secondary occlusion of the liver veins as a result of IVC thrombosis, while in a third case there was non-thrombotic proliferative disease of the wall of the small hepatic veins, closely similar to veno-occlusive disease. In a 19-year-old girl in whom thrombosis of the vena cava (with signs of liver-vein occlusion) occurred after pregnancy, revascularisation was achieved by fibrinolytic treatment.

Hepatic occlusion venography with the aid of a Swan-Ganz balloon catheter represents a significant improvement in the radiographic demonstration of hepatic veins and their alteration in liver disease. It is simple to perform and can be combined with other hemodynamic examinations (e.g., hepatic vein pressure measurements). In this way the morphologic and hemodynamic changes in the pre- and postoperative evaluation of patients with portal hypertension can be investigated simultaneously. The method allows optimal demonstration of large branches of hepatic veins. Overloading of small areas of liver parenchyma with concentrated contrast medium, as in wedged hepatic venography, is avoided. Previously unknown portosplanchnic anastomoses developing after end-to-side portacaval shunt were demonstrated in seven of eight patients using this method. The frequency and size of these collaterals suggest possible hemodynamic and clinical significance.