scholarly journals Noninvasive diagnosis of portal hypertension and esophageal varices through the identification of liver blood flow markers

Hepatology ◽  
2014 ◽  
Vol 60 (2) ◽  
pp. 762-762 ◽  
Author(s):  
Andrea Lisotti ◽  
Francesco Azzaroli ◽  
Marco Montagnani ◽  
Giuseppe Mazzella
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Liver Blood Flow ◽  
Noninvasive Diagnosis

The Effect of Artificial Portocaval Anastomosis or Splenectomy on Hepatic and Portal Haemodynamics in Cirrhotics

1969 ◽  
Vol 08 (03) ◽  
pp. 232-241
Author(s):  
J. Vosmík ◽  
V. Bláha
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Blood Flow ◽  
Severe Liver ◽  
Portocaval Anastomosis ◽  
Average Decrease ◽  
Modified Method ◽  
Portosystemic Shunts ◽  
Before And After

SummaryUsing their own modified method the authors simultaneously examined the blood clearances of 198Au colloid and 131I-Rose Bengal and determined the ratio1. in a group of 11 patients with severe liver cirrhosis, portal hypertension and portosystemic shunts, both before and after artificial portocaval anastomosis, and2. in two patients with thrombosis v. lienalis, excessive splenomegaly and extensive portosystemic shunts before and after splenectomy. Ad 1. In 6 patients 55%) a reduction of the effective liver blood flow occured due to the artificial portosystemic anastomosis; the average decrease was ~ 20%. In 7 patients a significant enlargement of the total splenosystemic flow was observed as a result of the artificial communication.Ad 2. In both patients an increase of the effective liver blood flow occured after splenectomy. The minimal preoperative splenosystemic flow was ~ 0.152 and ~ 0.089 of the circulating blood per minute (expressed by means of kAu).The authors discuss the significance of the kAu and kBR values as well as that of the ratio for the estimation of changes in hepatic and portal haemodynamics.

Effect of Endoscopic Sclerotherapy of Esophageal Varices on Liver Blood Flow and Liver Function: An Experimental Study

1987 ◽  
Vol 22 (5) ◽  
pp. 619-626 ◽  
Author(s):  
L. S. Jensen ◽  
N. Krarup ◽  
J. Anker Larsen ◽  
C. Juhl ◽  
T. Harboe Nielsen ◽  
...  
Keyword(s):  
Experimental Study ◽  
Blood Flow ◽  
Liver Function ◽  
Esophageal Varices ◽  
Liver Blood Flow ◽  
Endoscopic Sclerotherapy

scholarly journals The role of ultrasonography in the evaluation of portal hemodynamics in healthy adults and pathologic conditions

2016 ◽  
Vol 22 (2) ◽  
pp. 128-134 ◽  
Author(s):  
C. Anda Achim ◽  
P. Bordei ◽  
E. Dumitru
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Healthy Subjects ◽  
Portal Blood Flow ◽  
Control Group ◽  
Portal Hemodynamics ◽  
Cirrhotic Patients

AbstractIntroduction: Portal hypertension results from increased resistance to the portal blood flow. The ultrasound represents a noninvasive tool for assessing the structural and hemodynamic abnormalities in this condition.Objectives: The assessment of the hemodynamic blood flow of the liver and spleen by using Doppler ultrasound in patients with portal hypertension compared with healthy subjects and to identify correlations with the severity of liver cirrhosis and esophageal varices.Materials and Method: This study included 50 patients with liver cirrhosis and 20 healthy subjects as controls. Different correlations were carried out between hemodynamic variables obtained from the Doppler examination and the severity of cirrhosis as assessed by the Child score and the degree of esophageal varices at endoscopy.Results: The portal vein diameter was larger in cirrhotic patients compared with the control group. The mean portal vein velocity and the blood flow were significantly lower in advanced forms of liver cirrhosis. The portal vein congestion index, the pulsatility and resistivity indexes of the hepatic artery were significantly increased in patients with CHILD B and C cirrhosis compared with the control group and patients in CHILD class A. There were no statistically significant differences between the pulsatility and resistivity indexes of the splenic artery in patients with cirrhosis. The liver vascular index was significantly lower in patients with advanced cirrhosis.Conclusions: The ultrasound is a valuable noninvasive tool for cirrhotic patients with portal hypertension. However, it is not sufficiently accurate in differentiating between different classes of cirrhosis or degrees of esophageal varices.

scholarly journals Gastroduodenal Lesions Associated with Portal Hypertension: An Extensive Review

2021 ◽  
Author(s):  
Vincenzo Neri ◽  
Nicola Tartaglia ◽  
Alberto Fersini ◽  
Pasquale Cianci ◽  
Mario Pacilli ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Blood Flow ◽  
Clinical Practice ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Gastric Varices ◽  
Gastric Antral Vascular Ectasia ◽  
Extensive Review ◽  
Vascular Ectasia ◽  
Isolated Gastric Varices

The block of the portal flow by obstacles in prehepatic, hepatic or posthepatic site and alterations of the splanchnic blood flow are the pathological conditions that lead to portal hypertension. The portal hypertension can cause also others gastroduodenal lesions, potentially hemorrhagic, in addition to esophageal varices commonly developed and habitual source of bleeding in these patients. The gastroduodenal lesions associated with portal hypertension, usually encountered in the clinical practice, are portal hypertensive gastropaty, gastric antral vascular ectasia, gastric and duodenal ulcer, isolated gastric varices. The pathophysiology and clinical, diagnostic and therapeutic features of these lesions are examined.

Liver Blood Flow as a Major Determinant of the Clearance of Recombinant Human Tissue-Type Plasminogen Activator

1992 ◽  
Vol 67 (01) ◽  
pp. 083-087 ◽  
Author(s):  
A de Boer ◽  
C Kluft ◽  
J M Kroon ◽  
F J Kasper ◽  
H C Schoemaker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Rat Liver ◽  
Healthy Subjects ◽  
Liver Blood Flow ◽  
Major Determinant ◽  
Tissue Type ◽  
Perfused Rat Liver ◽  
Liver Model ◽  
Type Plasminogen Activator ◽  
Proportional Change

SummaryThe influence of changes in liver blood flow on the clearance of rt-PA was studied both in healthy subjects and in a perfused rat liver model. Liver blood flow in healthy subjects was documented indirectly by the clearance of indocyanine green (ICG). Exercise reduced liver blood flow on average by 57% with a 95% confidence interval (95% Cl) ranging from 51% to 62% (n = 5) and increased plasma levels of rt-PA activity (after an i. v. infusion of 18 mg of rt-PA over 120 min) by 119% (95% Cl, 58% - 203%) and rt-PA antigen by 91% (95% Cl, 30% - 140%). In the perfused rat liver model it was shown that halving or doubling of the physiological flow rate of a perfusate, containing rt-PA caused a proportional change in the clearance of rt-PA, while the extraction of rt-PA by the liver remained similar. In conclusion, liver blood flow is a major determinant of the clearance of rt-PA. This may have important implications for dosage of rt-PA in patients with myocardial infarction.

A young man with bleeding esophageal varices

2018 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Soonthorn Chonprasertsuk
Keyword(s):  
Risk Factors ◽  
Portal Hypertension ◽  
Liver Function ◽  
Physical Examination ◽  
Esophageal Varices ◽  
Noncirrhotic Portal Hypertension ◽  
Liver Histopathology ◽  
Bleeding Esophageal Varices

The noncirrhotic portal hypertension is an uncommon cause of bleeding esophagealvarices. This condition must be suspected in patients with preserved liver function. We reporta 25-year old man with SLE disease who presented with hematemesis. He had no historyor risk factors for an underlying liver condition. A huge splenomegaly was detectedby physical examination. The EGD found three large varices with red wale sign, whereas liverfunction tests were unremarkable. The noncirrhotic portal hypertension was diagnosedand confirmed by liver histopathology. Figure 1 แสดงผลการส่องกล้องทางเดินอาหารส่วนบนพบ F3 varices with red wale sign

scholarly journals High Feed Intake Increases Liver Blood Flow and Metabolism of Progesterone and Estradiol-17β in Dairy Cattle

2002 ◽  
Vol 85 (11) ◽  
pp. 2831-2842 ◽  
Author(s):  
S. Sangsritavong ◽  
D.K. Combs ◽  
R. Sartori ◽  
L.E. Armentano ◽  
M.C. Wiltbank
Keyword(s):  
Blood Flow ◽  
Dairy Cattle ◽  
Feed Intake ◽  
Liver Blood Flow ◽  
High Feed ◽  
Estradiol 17Β

scholarly journals A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Hany El-Assaly ◽  
Lamiaa I. A. Metwally ◽  
Heba Azzam ◽  
Mohamed Ibrahim Seif-Elnasr
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Imaging Modality ◽  
Splenic Vein ◽  
Gastric Varices ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
Vein Diameter

Abstract Background Portal hypertension is a major complication resulting from obstruction of portal blood flow, like cirrhosis or portal vein thrombosis, that leads to portal hypertension. MDCT angiography has become an important tool for investigation of the liver as well as potentially challenging varices by detailing the course of these tortuous vessels. This information is decisive for liver transplantation as well as for common procedures in which an unexpected varix can cause significant bleeding. Results This study included an assessment of 60 cases of portal hypertension (28 males and 32 females), their age ranged from 42 to 69 years (mean age = 57.2 ± 6.63). All patients were diagnosed with portal hypertension, underwent upper GI endoscopy followed by a triphasic CT scan with CT angiographic assessment for the screening of gastro-esophageal varices. CT is highly sensitive as compared to upper GI endoscopy (sensitivity 93%) in detecting esophageal varices. Gastric varices detected by CT in 22 patients (37%) compared to 14 patients (23%) detected by endoscopy. While paraesophageal varices were detected in 63% of patients and retro-gastric varices in 80% of patients that were not visualized by endoscopy. Our study reported that the commonest type of collaterals were the splenic collaterals, and we also found there is a significant correlation between the portal vein diameter and the number of collaterals as well as between the portal vein diameter and splenic vein diameter. Conclusions Multi-slice CT serves as an important non-invasive imaging modality in the diagnosis of collaterals in cases of portal hypertension. CT portography can replace endoscopy in the detection of high-risk varices. It also proved that there is a correlation between portal vein diameter, splenic vein diameter, and number of collaterals.

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