Portal vein Duplex study before and after operation of portal hypertension

ABSTRACT

Portal hypertension is an increase in the hydrostatic pressure within the portal vein or one of its tributaries. The aim of this work was duplex assessment of portal hypertension and duplex evaluation of haemodynamic changes before and after splenectomy and devascularization. The study included 30 persons divided into two groups 10 normal subjects as controls and 20 patients with portal hypertension. To both groups duplex Doppler was done to assess the portal vein diameter, portal vein caliber variation during respiration, splenic vein diameter, presence of collaterals, measuring portal vein velocity and the cross sectional area and then calculation of portal blood flow using the equation portal blood flow=velocity x cross sectional area. Of the present work showed that, in the control group, the mean portal vein diameter was 1.1 +/- 0.08 cm and the portal blood flow was 1.5 +/- 0.4 L/M. The pre-operative duplex study showed a mean velocity of 26.4 +/- 8.82 cm/sec. The mean portal blood flow was 1.2 +/- 0.6 L/M. The portal vein diameter ranged between 1.2 and 2.1 cm with mean 1.83 +/- 0.34 cm. The post -operative duplex study showed that the portal vein diameter ranged between 1 and 2 cm with a mean of 1.57 +/- 0.24 cm, the mean velocity ranged from 9 to 35.4 cm/sec with a mean 24.17 +/- 7.81 cm/sec. The portal blood flow ranged from 0.36 to 1.5 L/M with a mean of 0.78 +/- 0.34 L/M. The study of splenectomy and devasculariziation was done on 20 patients and portal blood flow was measured before and after surgery. Of the present work showed decrease in the portal blood flow in 18 patients out of 20 [90%]. This study showed decreased in portal vein diameter in 17 patients [85%] and no change in 3 cases [15%]. This was explained by drop of portal pressure that occurred after operation