Splanchnic blood flow in patients with cirrhosis and portal hypertension: investigation with duplex Doppler US.

Abstract

Blood flow is increased in the SMAs and splenic arteries of patients with cirrhosis and portal hypertension. Increased splanchnic blood flow associated with cirrhosis may occur exclusively in patients with splenomegaly.

Color Doppler velocity profile assessment of portal hemodynamics in cirrhotic patients with portal hypertension: Correlation with esophageal variceal bleeding

“…An increased percentage of pattern II (phasic) flow in the splenic vein suggested that the increased flow in the splenic vein came from increased flow in the splenic artery, as has been observed in previous studies. 23,24 In the portal trunk, the congestion index was markedly elevated, and the CSVmax was substantially reduced, suggesting passive congestion. At the same time, the flow volume in the portal trunk was considerably increased.…”

Superior mesenteric artery blood flow in patients with small bowel diseases: Evaluation with duplex Doppler sonography

“…10 In cirrhotic patients, hemodynamic alterations in the SMA flow have been reported to be due to a hyperdynamic flow state. 11,12 In addition, the physiology literature shows that intestinal distention, venous pressure elevation, and hemorrhage may influence the blood circulation in the intestinal wall. 2,13 Atherosclerotic lesions, particularly in patients older than 65 years, may involve the SMA and impair the arterial supply of the small bowel.…”

“…15 In the control group, we found the SMA blood flow volume (0.692 ± 0.250 l/min) to be greater than the previously reported duplex Doppler data on healthy subjects (0.377 ± 0.166 l/min to 0.550 ± 0.30 l/min). 11 This difference could be due to the conditions in which the measurements were made, the body habitus of the subjects, or technical factors related to Doppler equipment. In a discussion of the main limitations and difficulties of the duplex Doppler method, Qamar et al reported that the calculated SMA blood flow volume is slightly underestimated mainly because of errors in diameter measurements.…”

“…11,[17][18][19][20] The most important error is related to measurement of vessel diameter. In a vessel with a diameter of 7 mm (such as the SMA), the maximum error in measurement of the diameter is 17%.…”

Veia paraumbilical pérvia: importância hemodinâmica na hipertensão portal por esquistossomose mansônica hepatoesplênica. (Estudo com ultra-sonografia Doppler)

“…A hipertensão portal, tanto na esquistossomose mansônica hepatoesplênica como na cirrose hepática, resulta do bloqueio venoso portal intra-hepático e é modulada pelo aporte sangüíneo (25) e pela drenagem colateral portossistêmica espontânea (13) . Estas vias de circulação venosa alternativa, ao ajudarem na vazão do sangue portal represado, são fatores de compensação da hipertensão portal de tal importância, que a interrupção parcial de uma delas (escleroterapia endoscópica das varizes esofágicas) provoca o aumento da pressão portal (13) .…”