Computed tomography evaluation of patent paraumbilical vein and its aneurysm in relation to other portosystemic collateral channels in patients with liver cirrhosis and portal hypertension

Objective: to evaluate the prospects and role of the methods of imaging (ultrasound and CT) in the diagnosis of the pathogenic aspects of the development and correction of portal hypertension in liver cirrhosis. Material and methods. Patients with liver cirrhosis and portal hypertension, Doppler ultrasound, multislice computed tomography. Conclusion. The combined use of ultrasound and computed tomography facilitates tracing of the dynamics of the disclosure of portocaval anastomoses and predict the course of liver cirrhosis and portal hypertension. The application of the integrated ultrasound to determine the rate of blood flow volume in vessels of portal system and portocaval anastomosis will enable development of differential diagnostic criteria for the early diagnosis of portal hypertension. The detection of recanalized umbilical vein by means of 3D-visualization of its anatomy makes it possible to use it for delivering of therapeutic agents to the liver in its pathology.

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Risk Factors for Esophageal Collateral Veins in Cirrhosis with and without Previous Endoscopic Esophageal Variceal Therapy

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2022/6666791 ◽

2022 ◽

Vol 2022 ◽

pp. 1-13

Author(s):

Qianqian Li ◽

Xiaozhong Guo ◽

Ji Feng ◽

Xiangbo Xu ◽

Saurabh Chawla ◽

...

Keyword(s):

Risk Factors ◽

Liver Cirrhosis ◽

Portal Hypertension ◽

Esophageal Varices ◽

Injection Sclerotherapy ◽

Gastroesophageal Varices ◽

Subgroup Analyses ◽

Portosystemic Collateral ◽

Independent Risk Factors ◽

Collateral Vessels

Background. Portosystemic collateral vessels are a sign of portal hypertension in liver cirrhosis. Esophageal collateral veins (ECVs) are one major type of portosystemic collateral vessels, which increase the recurrence of esophageal varices and bleeding after variceal eradication. However, the risk factors for ECVs were still unclear. Methods. We retrospectively screened cirrhotic patients who had contrast-enhanced computed tomography (CT) images to evaluate ECVs and upper gastrointestinal endoscopic reports to evaluate gastroesophageal varices at our department. Univariate and multivariate logistic regression analyses were performed to explore the independent risk factors for ECVs. Odds ratios (ORs) were calculated. Subgroup analyses were performed in patients with and without previous endoscopic variceal therapy which primarily included endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS). Results. Overall, 243 patients were included, in whom the prevalence of ECVs was 53.9%. The independent risk factors for ECVs were hepatitis C virus infection (OR = 0.250, p = 0.026), previous EVL (OR = 1.929, p = 0.044), platelet (OR = 0.993, p = 0.008), and esophageal varices needing treatment (EVNTs) (OR = 2.422, p = 0.006). The prevalence of ECVs was 60.8% (73/120) in patients undergoing EVL, 50% (10/20) in those undergoing EIS, and 47.5% (48/101) in those without previous endoscopic variceal therapy. The independent risk factors for ECVs were the use of nonselective beta-blockers (OR = 0.294, p = 0.042) and EVNTs (OR = 3.714, p = 0.006) in subgroup analyses of patients with and without previous endoscopic variceal therapy, respectively. Conclusions. The presence of ECVs should be closely associated with the severity of portal hypertension in liver cirrhosis. Risk of ECVs might be increased by previous EVL.

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Small intestinal motillity disturbances and bacterial overgrowth in patients with liver cirrhosis is associated with portal hypertension

Gastroenterology ◽

10.1016/s0016-5085(01)81115-x ◽

2001 ◽

Vol 120 (5) ◽

pp. A224-A224

Author(s):

A GUNNARSDOTTIR ◽

E BJOMSSON ◽

G RINGSTROM ◽

M SIMREN ◽

P STOTZER ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Bacterial Overgrowth ◽

Small Intestinal

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Endothelins and natriuretic peptides in liver cirrhosis with portal hypertension

Journal of Hepatology ◽

10.1016/s0168-8278(01)80226-9 ◽

2001 ◽

Vol 34 (0) ◽

pp. 66

Author(s):

S Battista

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Natriuretic Peptides

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Von Willebrand Factor/thrombocytes (VITRO Score) and its diagnostic role as a non-invasive predictor of decompensation, mortality and portal hypertension in patients with compensated liver cirrhosis

Zeitschrift für Gastroenterologie ◽

10.1055/s-0036-1584059 ◽

2016 ◽

Vol 54 (05) ◽

Author(s):

R Schwarzer ◽

S Hametner ◽

A Ziachehabi ◽

S Gerstl ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Von Willebrand Factor ◽

Non Invasive ◽

Diagnostic Role ◽

Von Willebrand ◽

Willebrand Factor

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An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

Perspectives in Surgery ◽

10.33699/pis.2019.98.8.326-327 ◽

2019 ◽

Vol 98 (8) ◽

pp. 326-327 ◽

Cited By ~ 1

Keyword(s):

Liver Cirrhosis ◽

Abdominal Pain ◽

Case Report ◽

Portal Hypertension ◽

Liver Disease ◽

Epigastric Pain ◽

Umbilical Vein ◽

History Of ◽

Clinically Significant ◽

Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

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Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

The Heart Surgery Forum ◽

10.1532/hsf98.2013251 ◽

2014 ◽

Vol 17 (1) ◽

pp. 42

Author(s):

Shi-Min Yuan

Keyword(s):

Computed Tomography ◽

Liver Cirrhosis ◽

Female Patient ◽

Constrictive Pericarditis ◽

Delayed Diagnosis ◽

Young Female ◽

Refractory Ascites ◽

Diagnostic Challenge ◽

Massive Ascites ◽

History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

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Faculty Opinions recommendation of Treatment with the leukotriene inhibitor montelukast for 10 days attenuates portal hypertension in rat liver cirrhosis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718874827.793499789 ◽

2014 ◽

Author(s):

Tilman Sauerbruch

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Rat Liver

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Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease

Endoscopy International Open ◽

10.1055/a-1233-1934 ◽

2020 ◽

Vol 08 (11) ◽

pp. E1623-E1632

Author(s):

Carlos Robles-Medranda ◽

Roberto Oleas ◽

Miguel Puga-Tejada ◽

Manuel Valero ◽

Raquel Del Valle ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Liver Disease ◽

Chronic Liver Disease ◽

Predictive Value ◽

Strain Ratio ◽

Chronic Liver ◽

Spleen Stiffness ◽

Eus Elastography ◽

Sensitivity Specificity

Abstract Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease. Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %. Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively. Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis.

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