Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

20 May 2003 : Case report  

Correlation between the portal haemodynamics disorders,size of esophageal varices and incidence of variceal bleeding in patients with portal hypertension

P. Małkowski, J. Pawlak, B. Michałowicz, T. Wróblewski, E. Leowska, I. Grzelak, R. Paluszkiewicz, Jerzy Żurakowski

Med Sci Monit 2003; 9(2): 22-26 :: ID: 15306

Abstract

Background: The hypothesis evaluated in the study was the existence of correlation between blood flow direction and velocity in portal collateral circulation and the portal vein,the size of esophageal varices and variceal bleeding. The aim of the study was to confirm the afore- mentioned correlation and to determine whether the results would allow to optimize indications for preventive obliteration of esophageal varices in the group of patients characterized by high risk of hemorrhages. Material/Methods: From 1999 to 2002,118 patients (group I)with the history of variceal hemorrhages ,but not treated yet, and 80 patients (group II)with no history of hemorrhagic events despite the signs of portal hypertension and the presence of esophageal varices were included in the analysis.The characteristics evaluated in both groups included size of the esophageal varices ,direction and volume (mean velocity)of blood flow in the portal vein –if it was patent –or in the formed collateral circulation. The appearance and size of the esophageal varices were assessed by endoscopy. Portal hemodynamics disorders were evaluated by ultrasonography using a Doppler probe for blood flow mea- surements. Patients with the history of hemorrhages (group I) were examined once. The obtained results were used to determine the hemodynamic disorders characteristic of variceal bleeding and the corresponding size of varices. Group II was subjected to prospective evaluations. The baseline results constituted the reference point for further periodic check-ups monitoring the changes taking place in the portal system. The follow-up of the patients involved endoscopy and sonography performed at 2 –3 month intervals to evaluate the progression of the changes (according to the above criteria), with special attention paid to the onset of bleeding. The mean observation time in the prospectively evaluated group II was 24 months and ranged from 3 to 36 months.Results:In all the patients from group I, large and medium-sized varices were found. Patients with hepatopetal blood flow with mean flow velocity of 12 cm/s predominated. n most patients, collateral circulation with hepatofugal flow direction had been formed, which in 25 cases was effected through the left gastric vein. Small varices were predominant on base- line endoscopic assessment of group II. Patients with large and medium-sized varices constituted 28%of the group. During the analyzed follow-up period, the number of patients large and medium-sized varices increased. On final assessment they accounted for 52% of the whole group. Conversely, the number of patients with small varices decreased. Baseline ultrasonographic assessment (group II) demonstrated the predominance of patients with hepatopetal blood flow of 16 cm/s mean velocity. On final assessment, the number of such patients decreased along with the reduction of mean flow velocity in the portal vein. On the other hand, the number of patients with portal venous stasis or reversed flow direction increased during the analyzed period On baseline assessment, patients with hepatopetal or bidirectional portal flow in collateral circulation were found to predominate, whereas final assessment demonstrated the increase of the number of patients with hepatofugal collateral circulation formed during the observation period. The number of patients with hepatopetal blood flow in collateral portal circulation decreased. Variceal bleeding was noted in 19 (25%) patients from group II.Statistical analysis confirmed the existence of statistically significant differences at p

Keywords: portal hypertension, portal hemodynamics disorders, Doppler monitoring of portal flow and collateral circulation

Add Comment 0 Comments

Editorial

01 March 2024 : Editorial  

Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-Thalassemia

Dinah V. Parums

DOI: 10.12659/MSM.944204

Med Sci Monit 2024; 30:e944204

0:00

In Press

21 Feb 2024 : Clinical Research  

Potential Value of HSP90α in Prognosis of Triple-Negative Breast Cancer

Med Sci Monit In Press; DOI: 10.12659/MSM.943049  

22 Feb 2024 : Review article  

Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...

Med Sci Monit In Press; DOI: 10.12659/MSM.943168  

23 Feb 2024 : Clinical Research  

A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...

Med Sci Monit In Press; DOI: 10.12659/MSM.943732  

26 Feb 2024 : Clinical Research  

Predictive Value of Combined HbA1c and Neutrophil-to-Lymphocyte Ratio for Diabetic Peripheral Neuropathy in...

Med Sci Monit In Press; DOI: 10.12659/MSM.942509  

Most Viewed Current Articles

17 Jan 2024 : Review article  

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

16 May 2023 : Clinical Research  

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

14 Dec 2022 : Clinical Research  

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990

0:00

01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750