EVALUATION OF CASES OF PORTAL HYPERTENSION BY COLOUR DOPPLER AND ULTRASONOGRAPHY

Abstract

Dr. Karthikeyan B,

BACKGROUND:

In adults, the normal portal venous pressure is 5-10 mmHg. Portal hypertension is defined as portal venous pressure of more than at least 5 mmHg greater than the pressure in the hepatic veins or inferior vena cava.1 Clinically significant portal hypertension, sufficient to cause serious complications and therefore requiring treatment, is defined as an increase of 12 mmHg.The objective of the study is to study the role of ultrasound and colour doppler sonography in 1. evaluation of portal hypertension,2. identifying specific features of portal hypertension on these modalities, that permit its accurate diagnosis and 3. detecting the complications at an early stage. MATERIALS AND METHODSForty adult patients referred to the radiodiagnosis department of Sri Lakshmi Narayana Institute of Medical Sciences with clinical diagnosis of portal hypertension were included in study. All patients included in the study underwent ultrasonography (USG) of abdomen using a curvilinear and a sector probe of 3.5-5.0 MHZ coupled with colour Doppler equipment. Statistical analysis was done using percentage and proportions. RESULTSThe most common age group presenting with portal hypertension was between 51-65 years. The frequency of portal hypertension was more in males. Diameter of portal vein of >13 mm was seen in 53% and <13 mm was seen in 47% cases. Splenomegaly and ascites were frequently associated with portal hypertension.Thrombosis of veins was more commonly seen in portal vein. Most frequent collaterals were seen in splenorenal and gastro-renal group. Cirrhosis was the most common aetiology. Eight percent of cases showed less than 20% increase in diameter with deep inspiration. CONCLUSIONColour Doppler and USG helps in precise evaluation of vascular anatomy in portal hypertension, in establishment of aetiology, haemodynamic changes and detecting its complications.

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