Biliary stricture caused by portal biliopathy: diagnosis by EUS with Doppler US

Umphress, Jason L.; Pecha, Robert; Urayama, Shiro

doi:10.1016/s0016-5107(04)02216-3

Cited by 35 publications

(25 citation statements)

References 16 publications

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“…Endoscopic ultrasound has also been reported to be a sensitive (81%) and specific (93%) test to diagnose portal vein thrombosis. [92][93][94] Gallbladder varices on ultrasound have been seen in 12-30% of adults with chronic PVT. 95 …”

Section: Ultrasoundmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

150

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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Section: Ultrasoundmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

150

147

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“…En presencia de lesiones sólidas detectadas en el hilio hepático, la posibilidad de realizar una PAAF para realizar el diagnóstico diferencial con procesos neoplásicos, puede ser un argumento a favor de la utilización de esta técnica 15,16 (fig. 2).…”

Section: Discussionunclassified

Colangiopatía asociada a la hipertensión portal

Justo

Foruny

Tallón

et al. 2011

Gastroenterología y Hepatología

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“…ECD collaterals appear as dot like enhancing structures in the bile duct wall. 17,18 Ultrasonography has many shortcomings. High level of echoes in the porta hepatis may obscure the biliary system and CBD may be hidden behind multiple collaterals, seen as anechoic tubular and fibrotic structures.…”

Section: Role Of Imaging For Different Type Of Collateralsmentioning

confidence: 99%

“…19 The use of ultrasonography and EUS detects large PCD and ECD collaterals while smaller collaterals have been detected by color Doppler US (CDUS) (Figure 5a, b & Video 3), color Doppler EUS and intraductal EUS. 18,20,21 On EUS biliary varices are defined as multiple, large, serpiginous, anechoic vascular channels in and/or around the extrahepatic biliary tract 20 ( Figure 6a and b). Intraductal sonography of biliary varices associated with EHPVO has shown presence of varices in mid and lower part of CBD.…”

Section: Role Of Imaging For Different Type Of Collateralsmentioning

confidence: 99%

Portal Cavernoma Cholangiopathy: An Endoscopic Ultrasound Based Imaging Approach

Sharma

Rameshbabu²

2014

Journal of Clinical and Experimental Hepatology

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In patients with portal cavernoma cholangiopathy (PCC), appearance and location of collateral channels depends on extent and location of occlusive thrombus in the porto-mesenteric venous system. If the porto-mesenteric venous system is occluded near the formation of portal vein, blood tends to flow through collateral channels that form varices in and around the common bile duct. Though endoscopic ultrasound (EUS) is considered the investigative modality of choice for evaluating common bile duct obstruction, its role in evaluating collateral pathways in and around the common bile duct is poorly defined. This article reviews the anatomy, genesis and appearance of these collateral pathways in PCC. EUS identifies different layers of the common bile duct (CBD) wall and, in PCC, where varices are in close contact with or part of these different layers, can establish the relationship between them. Thus, EUS appears to be the investigation of choice for tracing the origin and course of collaterals in PCC. Careful study of varices in the common bile duct wall prior to ERCP for bile duct stones or biliary strictures may help to plan the procedure and to manage anticipated complications such as hemobilia. ( J CLIN EXP HEPATOL 2014;4:S53-S61) B oth porto-systemic and porto-portal collaterals can develop in response to chronic occlusion of the portal venous system. The location and extent of occlusive thrombus in the porto-mesenteric venous system determine the type of collaterals that eventually develop and the direction of collateral flow.

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Biliary stricture caused by portal biliopathy: diagnosis by EUS with Doppler US

Cited by 35 publications

References 16 publications

Portal Vein Thrombosis

Portal Vein Thrombosis

Colangiopatía asociada a la hipertensión portal

Portal Cavernoma Cholangiopathy: An Endoscopic Ultrasound Based Imaging Approach

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