scholarly journals Ultrasonographic evaluation of portal hypertnsion

Mediscope ◽  
2015 ◽  
Vol 2 (1) ◽  
pp. 27-31
Author(s):  
MS Ahamed ◽  
PK Chowdhury ◽  
AS Mohiuddin ◽  
MA Hossain ◽  
B Paik
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Splenic Vein ◽  
Cross Sectional Study ◽  
Oesophageal Varices ◽  
Deep Inspiration ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Mesenteric Veins ◽  
Diameter Variation

A descriptive type of cross-sectional study was done to measure diameters of splenic, superior mesenteric and portal veins with their variation with respiration in patients with portal hypertension. Trans-abdominal ultrasonography was used for the purpose among purposively selected 59 patients with chronic liver disease and portal hypertension using computer sonography with multiple probes having multiple frequency depending on physical built of subjects. The diameters of selected veins were measured in the course of expiration and deep inspiration. Mean age of respondents was 53.2 years with standard deviation of 11.4 years. 44 (74.6%) subjects were male, whereas 15 (25.4%) were female. In all cases oesophageal varices were present. Portal vein was clearly visualized in all cases, while splenic vein in 53 (89.8%) cases and superior mesenteric vein in 49 (83.1%) cases. During deep inspiration, diameter of portal vein was greater than 13 mm in 31 (52.5%), while ?13 mm in 28 (47.5%) of portal hypertensive cases. Of 31, lack variation in diameter during respiration was observed in 29 (93.6%) cases. Size of liver (length in mid-clavicular line) in 18 (30.5%) cases were between 96 to 115 mm, while in 19 (32.2%) cases it was within 116 to 135 mm and in 22 (37.3%) cases it was between 136 to 160 mm. In 36 (61.0%) cases surface of liver was irregular, while in 51 (86.4%) cases parenchymal echotexture of liver was coarse. Size of spleen was enlarged in 44 (74.6%) cases, and ascites was present in 47 (79.7%) cases. Diameter variation with breathing of splenic and superior mesenteric veins observed only in 5 (8.5%) patients. Lack of diameter variation of portal, splenic and superior mesenteric veins with respiration in ultrasonography is an indicator of portal hypertension.Mediscope Vol. 2, No. 1: 2015, Pages 27-31

scholarly journals Correlation between Endosonographic and Doppler Ultrasound Features of Portal Hypertension in Patients with Cirrhosis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
A. Wiechowska-Kozłowska ◽  
K. Zasada ◽  
M. Milkiewicz ◽  
P. Milkiewicz
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Doppler Ultrasound ◽  
Gastric Wall ◽  
Splenic Vein ◽  
Maximum Velocity ◽  
Invasive Procedure ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Cross Sectional

Purpose. Endoscopic ultrasound (EUS) permits the detailed visualization of clinically significant features of portal hypertension; however, it is an invasive procedure that is not widely available. The aim of this cross-sectional study was to determine whether a correlation exists between the features of portal hypertension detected using both Doppler ultrasound and EUS in subjects with liver cirrhosis.Materials and Methods. Analyzed cohort included 42 patients who underwent a detailed Doppler ultrasound focusing on the parameters of blood flow in the portal/splenic vein as well as an endoscopic/EUS procedure that included the assessment of the size and localization of “deep” varices.Results. The size of “deep” oesophageal varices detected with EUS exhibited no correlation with the parameters assessed by Doppler ultrasound. However, the size of the “deep” gastric varices detected using EUS correlated with the time averaged maximum velocity (Tmaxas well asVmin,Vmax) for the portal vein using Doppler ultrasound and exhibited a correlation with theVmaxandTmaxfor the splenic vein. No significant correlation was determined between the diameter of the azygous vein and the thickness of the gastric wall when seen on EUS versus the parameters measured with Doppler ultrasound.Conclusion. EUS provides important information regarding the features of portal hypertension, and in the case of “deep” oesophageal varices exhibits a limited correlation with the parameters detected by Doppler ultrasound. Thus, despite its invasiveness, EUS is a method that provides a reliable and unique assessment of the features of portal hypertension in patients with liver cirrhosis.

scholarly journals Diagnosis of portal hypertension by transabdominal ultrasound

2015 ◽  
Vol 47 (1-2) ◽  
pp. 21-24
Author(s):  
Md Saad Ahamed ◽  
Shikha Kabir ◽  
AS Mohiuddin ◽  
Poritosh Kumar Chowdhury
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Superior Mesenteric Vein ◽  
Statistical Significance ◽  
Venous Pressure ◽  
Splenic Vein ◽  
Deep Inspiration ◽  
Mesenteric Veins ◽  
Mesenteric Vein ◽  
Imaging Department

Portal hypertension is pathologic increase in portal venous pressure, with diversion of portal blood to the systemic circulation. The study was directed to measure as well as to compare the diameters of splenic, superior mesenteric and portal veins with their variation with respiration in normal subjects and in patients with portal hypertension. An analytic type of cross-sectional study was conducted at Radiology and Imaging Department of BIRDEM, Shahbag, Dhaka for one year (2011-12) among purposively selected 59 study subjects with chronic liver disease and portal hypertension, and 45 individuals without liver disease. Transabdominal ultrasonograpy of hepatobiliary system was carried out using computed sonography system with multiple probes having multiple frequency depending on physical built of the subjects. The diameters of selected veins were measured in the course of expiration and deep inspiration. In all control subjects, diameter variations of splenic vein and superior mesenteric vein were noted in the phases of respiration, the diameters increased during deep inspiration and decreased during deep expiration mean diameter and standard deviation of splenic vein and superior mesenteric vein were 6.95 ± 1.75 mm and 8.77 ± 2.06 mm respectively and during expiration they were 4.45 ± 1.24 mm and 5.66 ± 1.41 mm respectively. The difference in deep inspiratory and expiratory diameters had high statistical significance (p<0.0001). Patients with portal hypertension diameter variation with breathing at the level of splenic and superior mesenteric veins was observed only in 5 (9.47%) cases. Diminished response of splenic and superior mesenteric veins with respiration in transabdominal ultrasonography is an indicator of portal hypertension. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22558 Bang Med J (Khulna) 2014; 47 : 21-24

scholarly journals Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease

2018 ◽  
Vol 5 (1) ◽  
pp. 159
Author(s):  
Suresh I ◽  
Shiva Prasad Jagini
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Portal Vein ◽  
Concentration Gradient ◽  
Independent Predictor ◽  
Alcoholic Cirrhosis ◽  
Cross Sectional Study ◽  
Albumin Concentration ◽  
Sectional Study ◽  
Cross Sectional

Background: In many studies Serum ascitic albumin gradient (SAAG) was found to be an independent predictor of PHTN and EV especially in alcoholic cirrhosis. Objectives of this study was to study correlation of level of “Serum-Ascites Albumin Concentration Gradient” (SAAG) and complications of “Portal hypertension” (PHTN), manifested by “Esophageal Varices” (EV).Methods: Present study was hospital based cross sectional study. The sample (100) was of patients with ascites. SAAG was measured in all subjects. EV was assessed by endoscopy in all. Data was analyzed using proportions and appropriate statistical tests.Results: High SAAG value was seen in 79% of the patients. EV incidence was 84.5%. “child-pugh score” and size of the portal vein was found to be associated with EV. The incidence of EV among patients with high “SAAG value of 1.1 to 1.44 g/dl” was 50%. The size of the EV was found to be significantly associated with SAAG level.Conclusions: Patients having ascites with EV were also having high levels of SAAG. Thus, we conclude that value of SAAG more than or equal to 1.2±0.05 g/dl can be used as a predictor of EV presence among ascites patients.

scholarly journals Clinical and Endoscopic Profile of Upper Gastrointestinal Bleed: A Cross-sectional Study from a Tertiary Care Hospital in Southern India

2021 ◽  
Author(s):  
Manju Surendran ◽  
K Sunil Kumar
Keyword(s):  
Portal Hypertension ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Southern India ◽  
Oesophageal Varices ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Upper Gastrointestinal

Introduction: Acute Upper Gastrointestinal (UGI) bleed is a common potentially life threatening emergency. The aetiological profile of bleed and prognosis varies according to geographical region and availability of endoscopic facilities. Aim: To determine the clinical and endoscopic profile of UGI bleed, risk factors and prognosis in the patients. Materials and Methods: This was a cross-sectional study conducted over a period of 12 months at a tertiary care centre in Southern India. Patients admitted with history of hematemesis and melena, satisfying the inclusion criteria was taken consecutively. Clinical and endoscopic profile were noted and followed-up for six weeks. Statistical analysis was performed using chi-square test for qualitative variables and independent t-test for quantitative variables. Significance level was fixed as p-value of <0.05. Results: A total of 138 patients were studied in this period. The male to female ratio in the study was 3.5:1. The mean age was 53.5±13.17 years. The most common clinical presentation was hematemesis in 57 patients (41.3%) followed by haematemesis and melena in 46 patients (33.3%). The most common cause on endoscopy was portal hypertension-related oesophageal and gastric varices (51.4%) followed by antral gastritis (15.2%). The cause of UGI bleeding could not be identified in 5.1% in which the endoscopy was normal. Haemogram, platelet count and serum albumin were significantly lower in variceal bleed group, compared to non-variceal group. Eleven patients succumbed to death secondary to UGI bleed. Conclusion: The most common causes of UGI bleed are portal hypertension related gastric and oesophageal varices. The in-hospital mortality in the study was 7.9%.

Reliability of Plasma Von Willebrand Factor Antigen in Prediction of Oesophageal Varices in Pediatric and Adolescent Patients with Portal Hypertension

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Lerine B Eldin ◽  
Asmaa W Abd Elaziz ◽  
Dina A Ragab ◽  
Karim A Abdelhady
Keyword(s):  
Portal Hypertension ◽  
Cross Sectional Study ◽  
Oesophageal Varices ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Invasive ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Larger Sample ◽  
Factor Antigen

Abstract Background Ruptured oesophageal varices (OVs) is a major cause of mortality in Portal hypertension (PHT) patients, It has been a great issue of interest and research to screen and early detect OVs via oesophageal varices non-invasive methods. Objective The aim of this study was to assess the reliability of measuring plasma von willibrand factor antigen (VWF-Ag) for prediction of the occurrence of oesophageal varices in patients with portal hypertension. Subjects & Methods This was a prospective cross-sectional study, done on 47 children with portal hypertension. The children were recruited from Pediatrics Hepatology clinic, Ain Shams University. Patient’s data was collected including age, sex, etiology and duration of PHT, along with medical treatment. Also an upper GIT endoscope, abdominal doppler ultrasound, and laboratory tests including measuring of plasma VWF-Ag were done to each patient. Then the children were divided based on their endoscopic findings into two groups; variceal group which included 37 patients, and a nonvariceal group which included 10 patients Results: The results of our study revealed an elevated plasma VWF-Ag in patients with oesophageal varices, whilst normal levels of plasma VWF-Ag in the non-variceal patients. In addition, there was a direct positive correlation between increased plasma VWF-Ag and the degree of oesophageal varices. Conclusion Since the plasma VWF-Ag level correlates with the presence and degree of OVs, it can be used as a noninvasive indicator of the presence and degree of OVs, However, further studies using larger sample might be needed to support this.

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.

P0157 : Adherence and safety of beta-blockers in elderly patients with cirrhosis and portal hypertension: A multi-center cross-sectional study

2015 ◽  
Vol 62 ◽  
pp. S361
Author(s):  
V. La Mura ◽  
C. Sylvestre ◽  
L. Pasina ◽  
A. Nobili ◽  
M. Primignani ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Elderly Patients ◽  
Beta Blockers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Sonographic features of portal hypertension in Schistosomiasis Mansoni

1994 ◽  
Vol 36 (4) ◽  
pp. 355-361 ◽  
Author(s):  
Rogerio Augusto Pinto-Silva ◽  
Wilson Luiz Abrantes ◽  
Carlos Maurício Figueiredo Antunes ◽  
Jose Roberto Lambertucci
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Splenic Vein ◽  
Diagnostic Value ◽  
Schistosomiasis Mansoni ◽  
Upper Limit ◽  
Splenic Hilus ◽  
Hepatosplenic Schistosomiasis

The diagnostic value of real-time sonography in the study of portal hypertension was assessed in 66 patients with hepatosplenic schistosomiasis mansoni, all with Symmers's fibrosis and esophageal varices. Seventy-one individuals without schistosomiasis were selected as controls. The inner diameters of the portal vessels were measured by sonography in all patients and controls: splenoportography was also performed in the schistosomal group. Intra-splenic pressure was over 30 cm of water in 44 of 60 patients with schistosomiasis. The upper limit of normality for portal vessel diameters was set through receiver operating characteristic curve at 12 mm for portal vein, 9 mm for splenic vein at splenic hilus, and 9 mm for superior mesenteric vein. The best discriminative vein for the diagnosis of portal hypertension was the splenic vein followed by the portal vein. A direct correlation was observed between the diameter of the splenic vein, measured by sonography, and the intra-splenic pressure. Except for the paraumbilical and mesenteric veins, more frequently identified by sonography, there was no statistical difference in the frequency of visualization of splanchnic vessels by sonography or splenoportography.

scholarly journals Diagnosis and management of extrahepatic oesophageal variceal bleed in children in a low resourced setting

2020 ◽  
Vol 54 (4) ◽  
pp. 274-278
Author(s):  
Taiba J. Afaa ◽  
Kokou H. Amegan-Aho ◽  
Elikem Richardson ◽  
Bamenla Goka
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Upper Gastrointestinal Bleeding ◽  
Liver Function Tests ◽  
Tertiary Hospital ◽  
Secondary Prophylaxis ◽  
Resource Constraint ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal

Extrahepatic portal vein obstruction (EHPVO) is a major cause of portal hypertension (PH) in children. Portal vein thrombosis (PVT) is the most common cause accounting for up to 75% of cases in developing countries. Upper gastrointestinal bleeding is the most dreaded and commonest presentation of portal hypertension. Successful treatment of paediatric PH, though challenging is performed in resource constraint countries. Cases: Five children presented over three years to a tertiary hospital in Ghana, with massive upper gastrointestinal bleeding. They had anaemia, thrombocytopaenia and four had splenomegaly. Liver function tests, INR, haemoglobin electrophoresis as well as HIV serology, hepatitis B and C screening were all normal. Abdominal doppler ultrasound scan confirmed portal vein thromboses. They were resuscitated and managed with octreotide, propranolol, antibiotics and sclerotherapy or oesophageal variceal banding in the acute setting and long term secondary prophylaxis with propranolol. Subsequently, an algorithm was developed to assist with the management of bleeding from oesophageal varices and the diagnosis of EHPVO. Conclusion: Portal hypertension due to EHPVO is an important cause of upper gastrointestinal (GI) bleeding in children. This can be successfully managed even in a resource constraint setting once the appropriate measures are taken.

scholarly journals Are Vaspin and Omentin-1 Related to Insulin Resistance, Blood Pressure and Inflammation in NAFLD Patients?

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Fereshteh Aliasghari ◽  
Azimeh Izadi ◽  
Masoumeh Jabbari ◽  
Bahareh Imani ◽  
Bahram Pourghassem Gargari ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Cross Sectional Study ◽  
Serum Glucose ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Glucose Levels ◽  
Partial Correlations ◽  
Hs Crp

Summary Background: Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of insulin resistance, is the most common cause of chronic liver. The present study aimed to investigate the roles of Vaspin and omentin-1 in the NAFLD-related pathology including IR, inflammation and elevated blood pressure. Methods: This cross-sectional study was conducted among 83 NAFLD patients in Jahrom, Iran. Plasma levels of omentin-1, Vaspin, hs-CRP and IL-6 were measured. Anthropometric indices, lipid profiles, liver enzymes as well as abdominal ultrasonography were assessed. Results: Partial correlations controlling for age and sex showed significant positive correlation between Vaspin and fasting blood sugar (FBS), insulin, HOMA-IR, and hs-CRP. It has been observed that omentin negatively correlated with glucose levels. Moreover, a marginally significant association has been found between Omentin levels and systolic blood pressure (SBP). Conclusions: This study shows that Vaspin and Omentin-1 are associated with inflammation, insulin resistance and serum glucose levels in patients with NAFLD.

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