Echodoppler measurments of portal venous system in portal hypertension due to schistosomal hepatic fibrosis

ABSTRACT

This work was carried out on thirty adult male patients with portal hypertension due to schistosomal hepatic fibrosis, and ten age matched normal individuals as controls. All patients and control were examined clinically, by ultrasonography and by echodoppler for measurement of congestion index, maximum blood flow velocity, mean blood flow velocity, blood flow volume and cross sectional area of portal vein and transplenic portal venous pressure. The congestion index is a new parameter of hepatic hemodynamics. It is increased in SHF up to two and a half times the normal values [0.266 +/- 0.128/0.096 +/- 0.03]. It means show an increase in the cross sectional area of portal vein [2.44 +/- 1.1/1.23 +/- 0.42] and significant decrease in the mean blood flow velocity [9.4 +/- 11.88/12.85 +/- 1.99]. The resultant significant increase in blood flow volume of portal circulation [1396 +/- 675/1173 +/- 478] favours increased collateral blood flow and directly correlates with the incidence of bleeding gastro-oesophageal varices. The congestion index has a positive direct correlation with the CSA, and correlates negatively with blood flow velocity. It reflects an augmented hepatic vascular resistance to portal venous perfusion