scholarly journals Dopplervelocimetric evaluation of portal vein as a diagnostic tool for portosystemic shunt diagnosis in dogs

2009 ◽  
Vol 39 (5) ◽  
pp. 1433-1437 ◽  
Author(s):  
Cibele Figueira Carvalho ◽  
Giovanni Guido Cerri ◽  
Maria Cristina Chammas
Keyword(s):  
Portal Vein ◽  
Flow Velocity ◽  
Vena Cava ◽  
Portosystemic Shunt ◽  
Portal Flow ◽  
Liver Size ◽  
Hemodynamic Assessment ◽  
Duplex Doppler ◽  
Clinical Records ◽  
Tortuous Vessel

The objective of this research was to verify if the study of portal hemodynamic parameters through duplex Doppler ultrasonography (DUS) is able to help to detect portosystemic shunt (PSS) and the shunted vessel origin. It was detected PSS in 20 dogs by abdominal DUS and confirmed at surgery or necropsy from March of 2004 until March 2007. Main ultrasonographic findings were: identification of a tortuous vessel shunting portal flow being: portocaval shunt (16/20 or 80%), esplenocaval shunt (2/20 or 10%), gastrocaval shunt (1/20 or 5%), portoazigo shunt (1/20 or 5%); 2) elevated portal flow velocity before shunt (17/20 or 81%), 3) lower portal flow velocity after shunt (17/20 or 81%), 4) turbulence in the caudal vena cava (10/20 or 47,5%) and 5) reduced liver size (15/20 or 71%). The others ultrasonographic findings associated with clinical records were similar to that described in literature. With this work we could conclude that hemodynamic assessment of portal vein with DUS may be a useful tool for PSS diagnosis and to detect the shunted vessel origin.

Duplex-Doppler ultrasonography in the assessment of portal hypertension. Utility of the measurement of maximum portal flow velocity

1993 ◽  
Vol 17 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Piero D'Alimonte ◽  
Giorgio Cioni ◽  
Alessandro Cristani ◽  
Alberto Ferrari ◽  
Ezio Ventura ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Flow Velocity ◽  
Doppler Ultrasonography ◽  
Portal Flow ◽  
Duplex Doppler

scholarly journals Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Fuliang He ◽  
Shan Dai ◽  
Zhibo Xiao ◽  
Lei Wang ◽  
Zhendong Yue ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Vena Cava ◽  
Multivariate Logistic Regression Analysis ◽  
Meld Score ◽  
Portosystemic Shunt ◽  
Pathological Features ◽  
Intrahepatic Portosystemic Shunt ◽  
Artificial Channel

Background. Transjugular intrahepatic portosystemic shunt (TIPS) is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE); previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS. Methods. We recruited 361 patients who suffered from portal hypertension symptoms and were treated with TIPS from January 2009 to December 2012. Results. Multivariate logistic regression analysis showed that the risk of shunt stenosis was increased with more severe inflammation in the liver tissue (OR, 2.864; 95% CI: 1.466–5.592; P=0.002), HE comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P<0.001), or higher MELD score (95% CI, 1.298–1.731; P<0.001). Higher risk of HE was associated with shunt stenosis comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P<0.001), higher stage of the liver fibrosis (OR, 2.431; 95% CI, 1.355–4.359; P=0.003), and higher MELD score (95% CI, 1.711–2.406; P<0.001). Conclusion. The pathological features can predict individual susceptibility to shunt stenosis and HE.

scholarly journals Surgical Ligation of Extrahepatic Shunt under Guidance of Doppler Ultrasound, Portography, and Portal Pressure Monitoring

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mitsugi Shimoda ◽  
Takayuki Shimizu ◽  
Keiichi Kubota
Keyword(s):  
Doppler Ultrasound ◽  
Portal Pressure ◽  
Vena Cava ◽  
Flow Speed ◽  
Portosystemic Shunt ◽  
Portal System ◽  
Pressure Monitoring ◽  
Portal Flow ◽  
Surgical Ligation ◽  
Disturbance Of Consciousness

A 54-year-old man with chronic hepatitis C was admitted to our hospital because of a disturbance of consciousness and hyperammonemia. Abdominal angiography revealed a portosystemic shunt between the superior mesenteric vein and inferior vena cava. Endoscopic examination showed no varix. As interventional treatment was unsuccessful, surgical ligation of the shunt was performed. After surgery, portography revealed a huge shunt. Before ligation, the portal pressure, portal flow speed, and volume at the umbilical portion were 24 H2O. 5.6 cm/s and 203 ml/min, respectively. Finally the shunt was ligated. The portal flow speed and volume increased for 14 days following surgery and then stabilized. No varices were observed postoperatively. Doppler ultrasound, portography, and portal pressure monitoring can be used to reveal haemodynamic changes in the portal system and justify surgical ligation of portosystemic shunt.

Duplex Doppler endosonography in the diagnosis of splenic vein, portal vein, and portosystemic shunt thrombosis

1995 ◽  
Vol 42 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Maurits J. Wiersema ◽  
Amitabh Chak ◽  
Kenyon K. Kopecky ◽  
Lisa M. Wiersema
Keyword(s):  
Portal Vein ◽  
Splenic Vein ◽  
Portosystemic Shunt ◽  
Shunt Thrombosis ◽  
Duplex Doppler

Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation Type Ib) With Associated Hepatocellular Carcinoma

2017 ◽  
Vol 20 (4) ◽  
pp. 354-362 ◽  
Author(s):  
Mark Benedict ◽  
Manuel Rodriguez-Davalos ◽  
Sukru Emre ◽  
Zenta Walther ◽  
Raffaella Morotti
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Vena Cava ◽  
Clinical Manifestations ◽  
Portosystemic Shunt ◽  
Congenital Absence ◽  
Nodular Regenerative Hyperplasia ◽  
Type I ◽  
Small Hepatocellular Carcinoma ◽  
Abernethy Malformation

Abernethy malformation, also termed congenital portosystemic shunt and congenital absence of portal vein is the result of malformation of the splanchnic venous system. Congenital portosystemic shunts are divided into extra- and intrahepatic shunts. Two shunts have been defined: Type I is characterized by the complete diversion of portal blood into the vena cava with an associated congenital absence of the portal vein. Type II is defined by an intact but diverted portal vein through a side-to-side, extrahepatic connection to the vena cava. The clinical manifestations of Abernethy malformation are diverse with a typical presentation consisting of hypoxia and hepto-pulmonary syndrome. Histologically, focal nodular hyperplasia, nodular regenerative hyperplasia, liver adenoma, hepatoblastoma, and hepatocellular carcinoma have all been reported. Herein, we report a case of Abernethy malformation, type Ib, in a 12-month-old male who was found to have a small hepatocellular carcinoma at the time of explant. The immunohistochemical characteristics in relation to the genetic aspects are discussed. To our knowledge, this is the first reported case of hepatocellular carcinoma developing in a patient who is under the age of 5 years with Abernethy malformation.

Risk Factors for Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Hepatocellular Carcinoma and Portal Hypertension

2015 ◽  
Vol 24 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Jiannan Yao ◽  
Li Zuo ◽  
Guangyu An ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Encephalopathy ◽  
Pressure Gradient ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Meld Score ◽  
Portosystemic Shunt ◽  
Portal Flow ◽  
Intrahepatic Portosystemic Shunt

Aims: This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. Method: Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were followed up for 2 years. Pre-TIPS, peri-TIPS and post-TIPS clinical variables were reviewed using univariate and multivariate analyses to identify risk factors for HE after TIPS. Results: The overall incidence of HE was 41% (114/279). Multivariate analysis showed an increased odds for HE in patients with: >3 treatments with transcatheter arterial chemoembolization (TACE) and/or trans-arterial embolization (TAE) (odds ratio [OR], 4.078; 95% confidence interval [95%CI], 1.748-9.515); hepatopetal portal flow (OR, 2.362; 95%CI, 1.032-5.404); high portosystemic pressure gradient (OR, 1.198; 95%CI, 1.073-1.336) and high pre-TIPS MELD score (OR, 1.693; 95%CI, 1.390-2.062). Odds for HE were increased 1.693 fold for each 1-point increase in the MELD score, and 1.198 fold for each 1-mmHg decrease in the post-TIPS portosystemic pressure gradient. Conclusion: The identification of clinical variables associated with increased odds of HE may be useful for the selection of appropriate candidates for TIPS. Results suggest that an inappropriate decrease in the portosystemic pressure gradient might be associated with HE after TIPS. In addition, >3 treatments with TACE/TAE, hepatopetal portal flow, and high MELD score were also associated with increased odds of HE after TIPS. Key words:  –  –  – .

Transcatherter therapy for hepatocellular carcinoma with tumor thrombi in the main branch of the portal vein or inferior vena cava.

Kanzo ◽  
1992 ◽  
Vol 33 (7) ◽  
pp. 531-540 ◽  
Author(s):  
Keiji TAICADA ◽  
Kenji NAKAMURA ◽  
Takao MANABE ◽  
Noriaki USUKI ◽  
Toshio KAMINOU ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Portal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Tumor Thrombi
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