ULTRASONOGRAPHIC STUDY OF PORTAL VENOUS SYSTEM IN PORTAL-HYPERTENSION AND AFTER PORTOSYSTEMIC SHUNT OPERATIONS

  • 1 January 1984
    • journal article
    • research article
    • Vol. 95  (3) , 261-269
Abstract
A total of 160 patients with portal hypertension were examined by means of ultrasonography [US] in order to evaluate the sensitivity of this technique in the diagnosis of intrahepatic portal hypertension and in the detection of portal vein thrombosis. Of these patients, 38 were selected for a portosystemic shunt and were reexamined after operation to assess the value of US as a screening test for the patency of surgical portosystemic shunts. In patients with intrahepatic portal hypertension the main US findings observed were dilatation of the portal trunk of > 1.3 cm (56.6% of cases), patency and dilatation of the umbilical vein (5.8%), presence of intraabdominal collateral vessels (11.6%), splenomegaly with dilatation of splenic vein radicles at the hilus (91.3%) and disappearance of normal caliber variations during respiration in splenic or mesenteric veins (78.5 and 88.4%, respectively). The disappearance of normal caliber variations proved a highly specific and sensitive finding. Partial or total occlusion of the portal trunk was observed at US in 19 of 21 (90.5%) patients with portal vein thrombosis. Surgical portosystemic shunts were displayed in 28 of 37 patients (75.7%). US seems to be the most important noninvasive tool in the diagnosis of portal hypertension. In patients selected for surgical portosystemic shunts US supplies morphologic data regarding liver parenchyma and abdominal vascular anatomy, and it should be performed as a routine screening test for assessment of surgical shunt patency.