RESUMO
Background: Current literature on Budd Chiari Syndrome [BCS] in children is limited
Objective: To evaluate Ultrasound Doppler imaging as non-invasive and non-ionizing method of detecting children with clinical suspicion of Budd Chiari Syndrome
Methodology: This was a cross-sectional study conducted from 1stJanuary 2016 to 31st December 2017. Seventeen patients with clinically suspected BCS of age < 12 years, both gender, were registered from outpatient department of tertiary care unit, over a period of one year. Ultrasound and Doppler sonography was performed in all patients. Visualization of hepatic veins and IVC were noted along with flow and spectral waveform patterns in IVC, hepatic veins and portal veins. Intra-hepatic collaterals, caudate lobe hypertrophy, hepatosplenomegaly and ascites were also documented. The data was entered and analyzed by SPSS version 20
Results: The study included 11 [64.70%] female and 6 [35.29%] male patients with a mean age of 1.01+/-0.55 years. All patients had clinical suspicion of BCS [yellow discoloration of skin or sclera 52.94%, epistaxis 5.88%, abdominal pain 94.11%, distended abdomen 88.23%, palpable liver 64.70%, ascites 88.23% patients]. Ultrasonography showed right, middle and left hepatic veins occlusion 52.94%, 29.41% and 41.17% patients, respectively. Hepatic veins flow was reversed in 29.41% and absent in 52.94% cases. Intrahepatic collaterals, caudate lobe hypertrophy, hepatomegaly, portal hypertension, portal vein thrombosis and partial thrombosis of IVC were seen in 58.82%, 64.70%, 76.47%, 41.17%, 5.88% and 11.76% patients, respectively. Portal vein flow was hepatopetal in 52.94% and hepatofugal in 23.52% cases
Conclusion: Doppler sonography is a useful, non-invasive and non-ionizing imaging modality to diagnose and follow-up of patients with Budd Chiari Syndrome
RESUMO
Background: Familiarity of the regular and commonest deviations of anatomy of the mesenteric venous system is of great significance for surgeons performing hepatobiliary, pancreatic and gastrointestinal surgeries
Objective: To delineate the variable anatomy of superior mesenteric vein and drainage site of inferior mesenteric vein on CT venograms
Methodology: A total of 114 patients undergoing helical CT venogram for pancreatic pathologies were included in this cross sectional study from 1stJanuary, 2014 to 31stJanuary, 2015 at Radiology department, Sharif Medical City Hospital, Lahore. The mesenteric venous system was analyzed in all patients. Appearance of the Superior Mesenteric Veins [SMV] and drainage site of the Inferior Mesenteric Veins [IMV] were assessed on CT venography. Two radiologists interpreted the images and reached a concensus on all findings. Data was analyzed by using SPSS version 20
Results: The study included 64 [56.14%] female and 50 [43.85%] male with a mean age of 49+/-4 years. The SMV was composed of single and double trunks around the splenoportal confluence in 109 [95.61%] and 4 [3.50%] patients, respectively. It was absent in 1 [0.8%] patient. The IMV were identified in all patients. The IMV was observed to drain into splenic vein in 40 [35.08%] patients, SMV in 59 [51.75%], the junction between the superior mesenteric vein and the splenic vein in 14[12.28%], and first jejunal trunk in 1 [0.8%] patient
Conclusion: Understanding of mesenteric venous tributaries is supportive for surgeons to safely perform peripancreatic surgery, and this study shows the
variability in its anatomy