Alterazioni morfologiche dell’apparato genitale femminile dopo anastomosi porta-cava nel ratto.

Porta-caval shunt determines the deviation of the portal blood into the systemic circulation, so that hepatotrophic factors that derive from the intestine bypass the liver, alter the metabolism of the sexual hormones and cause testicular atrophy in male rats, ovarian atrophy and uterine hypertrophy in female rats. Sixty female rats were used in this study: 40 underwent end-to-side porta-caval shunt, 10 underwent sham-operation and 10 rats were used as negative controls. Rats were sacrificed 3 and 6 months after surgery. Rats which underwent porta-caval shunt registered more evident loss of weight six months after surgery. Average weight of uterus was 280 mg after 3 months and 550 mg after 6 months, while average weight of ovary was 35 mg after 3 months and 25 mg after 6 months. In sham-operated and control groups we verified normal growth. In rats which underwent portacaval shunt we registered an increase in estrogen and progestin levels, while morphologically we noted an increase in the volume of uterus, ovarian glandular hyperplasia, atretic corpora lutea and cystic follicles. In conclusion, portacaval shunt alters the hepatic metabolism of estrogens, so that the elevated estrogen plasma level inhibits gonadotropin secretion and low levels of gonadotropin cause ovarian atrophy. The residue estrogen ovarian secretion however is sufficient to stimulate uterine hyperplasia so that dysplastic or neoplastic lesions could verify in uterus.