Beta
35815

Duplex Doppler and color Doppler assessment of hepatic circulation in cirrhotic patients with portal hypertension : Correlation with oesophageal and fundal variceal bleeding

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Critical Care Medicine

Advisors

Radhwan, Wahid A., El-Qadhi, Nabil M., El-Gengihi, Sherin M.

Authors

Sulayman, Souzan Fouad

Accessioned

2017-03-30 06:22:40

Available

2017-03-30 06:22:40

type

M.Sc. Thesis

Abstract

Upper gastrointestinal bleeding is a leading cause of death in patients with liver cirrhosis. In most cases haemorrhage originates from oesophageal varices, and the evaluation of the bleeding risk is based on oesophago-gastro-duodenoscopic data. The aim of this study was to use the colour Doppler duplex ultrasonography to identify cirrhotic patients with risk of variceal bleeding. 32 patients underwent upper endoscopy to ascertain the grades of the varices. For each patient portal vein, splenic vein and hepatic artery parameters were obtained. The patients were classified into two groups, according to the presence or absence of history of upper gastrointestinal bleeding. A third group consisted of 15 control subjects was used as reference range for the Doppler parameters. Splenic vein study proved to be a good predictive for variceal bleeding. Splenic vein diameter and mean flow volume were higher in bleeders than non bleeders group but, with no correlation with the grade of oesophageal varices in cirrhotic patients.The best cut off of splenic vein mean flow volume was 1726 ml/min with sensitivity 57.14% and specificity 87.50% . Also, SV/PV ratio was used to assess the contribution of splenic vein flow to portal vein flow , there was high significant difference between the bleeders and the non bleeders groups (1.09 versus 0.59 respectively). Portal vein velocity, flow volume, congestion index, direction of flow, middle hepatic vein waveform and hepatic artery indices are not reliable predictors of variceal bleeding.

Issued

1 Jan 2003

Details

Type

Thesis

Created At

05 Feb 2023