ABSTRACT
The aim of the present study was targeted toward the assessment of the state of the portal vein in cases of portal hypertension, to estimate the actual incidence of portal vein thrombosis in this cases and evaluate the role of this non invasive technique for the diagnosis and management of patients. The material of the present study comprised 54 patients clinically suggested to have portal hypertension 50 males and 4 females. Their age range from 20 to 65 years with mean value 39.71 years All patients were subjected to thorough history taking full clinical examination, routine laboratory investigations and ultrasonograghic examination The portal vein was dilated in 81% of the patients in the bleeder subgroup while in the non bleeder group all patients have dilated portal vein. On comparing the portal and splenic vein calibers in different groups we found that non ascitic have larger calibers than asctic subgroup. Also our patients with portal vein thrombosis have a larger portal vein diameter than non thrombolic cases and those with huge spleen caliber than those with moderately enlarged one. Our results perhaps could select the splenic vein caliber to be a more sensitive usher of bleeding rather than the portal vein. In our cases with portal hypertension we found that no cirrhotic patients had portal vein thrombosis except those subjected to pervious splenectmy or having a complicating liver cell carcinoma. Duplex Doppler ultrasonograghy had offered a confirmation of portal vein thrombosis and revealed 100% hepatoperal blood flow in the portal vein and 81% hepatofugal blood flow in the splenic vein. In conclusion, ultrasonograghic technique had definitely offered a non invasive method for assessement of the state of the portal vein, although it has mentioned some peculiar feature it have not answered much of questions that have been aroused as regard the syndrome of portal hypertension with its different intermingled parameters