No abstract availble.
Blood Flow Velocity ; Humans ; Hypertension, Portal/*ultrasonography ; Liver Cirrhosis/pathology ; Portal Vein/ultrasonography ; *Ultrasonography, Doppler

Congenital absence of the portal vein (CAPV) is a rare malformation in which intestinal and splenic venous flow bypasses the liver and drains directly into the systemic circulation via a congenital portosystemic shunt. We describe two cases of CAPV presenting as pulmonary hypertension that were initially suspected as primary pulmonary hypertension. However, subsequent ultrasonography and CT detected the absence of a portal vein and the presence of a portosystemic shunt. Pulmonary hypertension is a recognized complication of liver disease and portal hypertension. However, these two cases illustrate that CAPV may result in pulmonary hypertension without liver disease or portal hypertension.
Hypertension, Portal ; Hypertension, Pulmonary* ; Liver ; Liver Diseases ; Portal Vein* ; Portasystemic Shunt, Surgical ; Ultrasonography

Endoscopic drainage of pancreatic pseudocysts is the initial treatment of choice for symptomatic pancreatic pseudocysts and nonresolving pseudocysts. Recently, endoscopic ultrasound (EUS) has been used as a guide for transmural entry and the safer drainage of pancreatic pseudocysts. We report a case of therapeutic linear array EUS-guided pseudocyst drainage without the use of fluoroscopy in a patient with portal hypertension.
Drainage* ; Fluoroscopy* ; Humans ; Hypertension, Portal ; Pancreatic Pseudocyst* ; Ultrasonography

Esophagogastric varices are considered to be the most common complication in patients with portal hypertension. Among ectopic varices, rectal varices are infrequent but potentially serious complication. The etiology and pathogenesis of rectal varices remains controversial. Several kinds of treatment have been performed but standard treatment for rectal varices has not been established. Herein we report a case of rectal varix bleeding treated with endoscopic variceal ligation (EVL) and then evaluated by transrectal color doppler ultrasonography.
Hemorrhage* ; Humans ; Hypertension, Portal ; Ligation* ; Ultrasonography, Doppler, Color ; Varicose Veins*

Chronic liver disease is a major disorder worldwide. A better understanding of anatomy, blood flow, and pathophysiology may be a key issue for their proper management. Ultrasound (US) is a simple and non-invasive diagnostic tool in the abdominal field. Doppler mode offers real-time hemodynamic evaluation, and the contrast-enhanced US is one of the most frequently used modalities for the detailed assessment. Further development in digital technology enables three-dimensional (3D) visualization of target images with high resolution. This article reviews the wide ranges of application in the abdominal US and describes the recent progress in the diagnosis of chronic liver diseases.
Diagnosis ; Fibrosis ; Hemodynamics ; Hypertension, Portal ; Liver Diseases ; Liver ; Ultrasonography

OBJECTIVE: Studies have presented conflicting results regarding the accuracy of ultrasonography (US) for diagnosing portal hypertension (PH). We sought to identify evidence in the literature regarding the accuracy of US for assessing PH in patients with liver cirrhosis. MATERIALS AND METHODS: We conducted a systematic review by searching databases, including MEDLINE, EMBASE, and the Cochrane Library, for relevant studies. RESULTS: A total of 14 studies met our inclusion criteria. The US indices were obtained in the portal vein (n = 9), hepatic artery (n = 6), hepatic vein (HV) (n = 4) and other vessels. Using hepatic venous pressure gradient (HVPG) as the reference, the sensitivity (Se) and specificity (Sp) of the portal venous indices were 69-88% and 67-75%, respectively. The correlation coefficients between HVPG and the portal venous indices were approximately 0.296-0.8. No studies assess the Se and Sp of the hepatic arterial indices. The correlation between HVPG and the hepatic arterial indices ranged from 0.01 to 0.83. The Se and Sp of the hepatic venous indices were 75.9-77.8% and 81.8-100%, respectively. In particular, the Se and Sp of HV arrival time for clinically significant PH were 92.7% and 86.7%, respectively. A statistically significant correlation between HVPG and the hepatic venous indices was observed (0.545-0.649). CONCLUSION: Some US indices, such as HV, exhibited an increased accuracy for diagnosing PH. These indices may be useful in clinical practice for the detection of significant PH.
Hepatic Veins/ultrasonography ; Humans ; Hypertension, Portal/*diagnosis/*ultrasonography ; Liver Cirrhosis/*ultrasonography ; Middle Aged ; Portal Pressure ; Portal Vein/ultrasonography ; Prospective Studies ; Sensitivity and Specificity ; Vascular Resistance

Portal hypertension (PHT) is a common complication of liver cirrhosis, which could be measured by the means of portal vein pressure (PVP). However, there is no report about an effective and reliable way to achieve noninvasive assessment of PVP so far. In this study, firstly, we collected ultrasound images and echo signals of different ultrasound contrast agent (UCA) concentrations and different pressure ranges in a low-pressure environment based on an
Contrast Media ; Humans ; Hypertension, Portal/diagnostic imaging* ; Liver Cirrhosis ; Portal Vein/diagnostic imaging* ; Ultrasonography

Portal hypertension is a major pathophysiology in patients with cirrhosis. Portal pressure is the gold standard to evaluate the severity of portal hypertension, and radiological intervention is the only procedure for pressure measurement. Ultrasound (US) is a simple and noninvasive imaging modality available worldwide. B-mode imaging allows broad applications for patients to detect and characterize chronic liver diseases and focal hepatic lesions. The Doppler technique offers real-time observation of blood flow with qualitative and quantitative assessments, and the application of microbubble-based contrast agents has improved the detectability of peripheral blood flow. In addition, elastography for the liver and spleen covers a wider field beyond the original purpose of fibrosis assessment. These developments enhance the practical use of US in the evaluation of portal hemodynamic abnormalities. This article reviews the recent progress of US in the assessment of portal hypertension.
Contrast Media ; Elasticity Imaging Techniques ; Fibrosis ; Hemodynamics ; Humans ; Hypertension, Portal* ; Liver ; Liver Diseases ; Portal Pressure ; Spleen ; Ultrasonography* ; Ultrasonography, Doppler

Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the different characteristic flow patterns observed from the portal vein, hepatic artery, and hepatic vein in patients with liver cirrhosis or related complications and procedures. Knowledge of these different flow patterns provides additional information that may reinforce the diagnosis of cirrhosis, help in staging, and offer prognostic information for determining the direction of therapy. Doppler ultrasonography is invaluable when liver transplantation is being considered and aids in the diagnosis of cirrhosis and portal hypertension.
Diagnosis ; Fibrosis* ; Hepatic Artery ; Hepatic Veins ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Transplantation ; Portal Vein ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color

The paraumbilical vein is one of the anastomotic channels between the portal and systemic circulatory systems, and rupture of the intra-abdominal varix is an unusual complication of portal hypertension that can lead to life-threatening hemoperitoneum. We experienced a case of hemoperitoneum due to a ruptured paraumbilical vein revealed by ultrasonography (US), computed tomography (CT) and percutaneous transhepatic portography. The last mentioned demonstrated a dilated paraumbilical ve i n draining two branches of the left portal vein into the right external iliac vein, and we performed coil embolization at the site at which the presumed site of paraumbilical vein was presumed to cause hemoperitoneum. We describe this unusual case of hemoperitoneum due to a ruptured paraumbilical vein in a known liver cirrhosis patient in whom portal hypertension was treated by means of coil embolization.
Embolization, Therapeutic* ; Hemoperitoneum* ; Humans ; Hypertension, Portal* ; Iliac Vein ; Liver Cirrhosis ; Portal Vein ; Portography ; Rupture ; Ultrasonography ; Varicose Veins ; Veins*