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At least 19 recordsLinked to original sources

[The Doppler sonographic measurement of the blood flow in the portal vein system in portal hypertension].

Diagnostic potentialities of Doppler sonography in assessment of portal hemodynamics in patients with chronic active hepatitis and hepatic cirrhosis were compared to those of noninvasive (rheohepatography) and invasive (angiography) techniques. Dopplerograms of the portal vein and its branches are described in specific details. Meals and treatment with beta-adrenoblockers reducing portal hypertension are evaluated in relation to their influence on the portal hepatic circulation.

Adolescent↗

Enhanced visualization of the portal vein system in superior mesenteric arterial portography using prostaglandin E1.

The portal vein system was clearly visualized in superior mesenteric arterial portography using prostaglandin E1. Angiographic examination was performed in 68 patients with various liver diseases during the 2 year period from 1980 to 1981. Twenty microgram of prostaglandin E1 was injected into the superior mesenteric artery 30 seconds before injection of 60 ml of contrast medium. The main portal vein was visualized in all of 68 cases. A high rate of success for visualization of the intrahepatic portal vein system by prostaglandin E1 was achieved. The first branches of the intrahepatic portal vein were visualized in 100% of the cases, the second branches in 82%, the third branches in 44%, and the fourth branches in 4% in the right portal vein system. In the left portal vein system, the first branches were visualized in 87%, the second branches in 41%, and the third branches in 3% of the cases. The intrahepatic portal vein system was more clearly visualized in females than in males (P less than 0.05). This procedure is simple, safe and useful for clear visualization of the portal vein system.

Alprostadil↗

[Pressure topography of the portal vein system and its clinical implications].

Pressure topography of the portal vein system was investigated in 10 healthy dogs and 26 patients with portal hypertension. The pressure in all of the tributaries of the portal vein was significantly higher than that of the portal trunk in healthy dogs, with the pressure of left gastric vein being the highest. The normal pressure gradient and the hepatopetal blood flow were evidently shown. In case of portal hypertension, the pathophysiologic pressure topography of the portal venenous system was miscellaneous with the pressure of left gastric vein being lower than that of the portal trunk in 41.7% of the 26 patients, a phenomenon suggestive of effective decompression of the portal vein by the development of esophagogastriv varix.

Adolescent↗

[Ultrasound studies of the portal vein system in liver tumors].

The study was carried out on a group of 21 patients with liver tumours (20 of them primary) and thrombosis of the portal venous system. Thrombosis in the left portal vein system was found in 10 patients, in the portal vein stem in 9 patients and in the portal confluence in 2 patients. In 15 patients thrombosis developed in the presence of a multicentric liver neoplasm. Proaf of the presence of a thrombus on the main portal trunk in patients with documented liver tumour contraindicates surgical or non-surgical therapeutic manoeuvres. If a thrombus is incidentally found in the portal venous system, a careful search for a tumour in the portal vein systems is imperative. In case of any suspicious modification, fine needle-aspiration should be performed.

Carcinoma, Hepatocellular↗

Aberrant right gastric vein directly communicating with left portal vein system. Incidence and implications.

In 3 patients with primary hepatic malignancies, a communication between the right gastric vein and the left portal vein system was recognized at angiography. The right gastric vein entered directly into the left lateral portal veins in 2 patients and into the left medial portal veins in one. Portal angio-CT performed in one patient demonstrated a specific defect only in the left lateral superior area of the liver, consistent with the segmental opacification of the portal vein branch recognized on the angiogram. This rare communication was seen in 3 (1.5%) of 200 consecutive patients who underwent celiac angiography and is most likely an anomaly in which the right gastric vein directly enters the left portal vein instead of the portal vein trunk. When interpreting a filling defect not associated with a mass lesion on portal angio-CT for hepatic neoplasms or the right gastric vein communicating with the left portal vein system on the angiogram, this particular anomaly should be considered.

Adult↗

Tumor thrombi in the portal vein system originating from gastrointestinal tract cancer.

Intraluminal tumor thrombus in the portal vein (PV) system originating from gastrointestinal (GI) tract cancer is a rare condition. There are two types of such thrombi, one arising indirectly from metastatic liver cancer and the other directly from the primary lesion. We report here three patients with the direct type and two with the indirect type; i.e., a total of five patients with gastric or large intestinal cancer with PV tumor thrombus. In all patients, the primary lesion was surgically resected; in two patients, the tumor thrombus was easily extirpated by direct opening of the PV. It is noteworthy that a patient whose tumor thrombus could not be treated died of cancer with liver failure, caused by expansive growth of the PV tumor thrombus, 4 months after the finding of the PV thrombus. Because PV tumor thrombus may, possibly, determine the patient's length of survival, in addition to causing cancer progression, surgical thrombectomy, combined with resection of the primary cancer and metastatic liver cancer, should be considered for prolongation of survival, if all macroscopic lesions can be controlled and if the tumor thrombus is a synchronous and recent one.

Adenocarcinoma↗

[Duplex ultrasound of the liver and portal vein system].

Duplex ultrasound allows direct access to portal venous and hepatic vein hemodynamics. This method has been accepted as a reliable procedure to detect portal and splenic venous thrombosis, Budd-Chiari's syndrome, portosystemic collateralisation and changes in the portal venous blood flow direction with a high rate of sensitivity. Besides these qualitative findings Doppler flowmetry allows quantitative measurement of portal venous blood flow velocities. The estimation of portal hypertension and the prediction of the risk of variceal bleeding by quantitative Doppler flowmetry is of increasing clinical importance. In monitoring the efficiency of medicational prophylaxis against gastrointestinal bleeding is also helpful. Duplex ultrasound can be used to evaluate the function of portocaval shunts including the intrahepatic stent shunt as well as to detect vascular complications after liver transplantation. Furthermore the method is gaining importance in the diagnosis and monitoring of therapy of acute liver transplant rejection. In case of liver tumors duplex ultrasound is of value for tumor staging and provides information about the dignity on the basis of perfusion patterns.

Budd-Chiari Syndrome↗

Occult hepatocellular carcinoma in cirrhosis: value of ultrasound-guided biopsy of portal vein system thrombus.

We report two cases of occult hepatocellular carcinoma associated with alcoholic cirrhosis, in which the diagnosis of malignancy was respectively established by ultrasound-guided biopsy of umbilical vein and portal vein branch thrombus. When measurement of serum alpha-foetoprotein, and liver ultrasonography and/or computed tomography failed to clearly demonstrate hepatocellular carcinoma, the presence of a thrombosis of the portal vein system is highly suggestive of malignancy, which may be easily confirmed by venous biopsy.

Aged↗

Behavior of the portal vein system in man after laparotomy.

At the end of an abdominal operation, a Teflon catheter was inserted into the portal vein, where it remained for nine days. Thus, blood samples could be withdrawn for analyses, and pressures could be recorded. The investigations were carried out in 41 patients who had a gastric or intestinal operation and had an uncomplicated postoperative course. The pressures in the portal vein and the arterioportal oxygen content difference were constant with 7 to 8 millimeters of mercury and by 2 volume per cent, respectively, during the period of all nine postoperative days. The pressure gradient between portal and central veins was about 6 millimeters of mercury. By infusing 350 to 500 milliliters of dextran 60 on day one or two postoperatively, the cardiac output was elevated about one-third, the central venous pressure increased from 0.9 to 4.9 millimeters of mercury and the portal venous pressure increased from 7.8 to 9.7 millimeters of mercury. This means that the pressure difference between the portal and central veins diminished. Simultaneously, the oxygen content difference between the systemic and pulmonary artery decreased from 4.7 to 3.3 volume per cent and between the systemic artery and portal vein, from 1.8 to 1.3 volume per cent. By assuming a constancy of the oxygen consumption in the region of the mesenteric circulation during infusion, it can be calculated from the behavior of the arterioportal oxygen content difference that the flow increase in the portal vein nearly equals that of cardiac output. The physical transhepatic resistance decreased about 50 per cent.

Cardiac Output↗