Alternate pathways in hepatic venous outflow obstruction by color doppler imaging

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2007 (EN)
Alternate pathways in hepatic venous outflow obstruction by color doppler imaging (EN)

Venkataraman, J.
Velliyappillil Cherian, J.
Joseph, G.
Chandrasekaran, S.
Kumar Muthusamy, A.

Introduction: Primary Budd - Chiari syndrome is a curable form of portal hypertension. Doppler ultrasonography is an excellent tool in the primary diagnosis of Budd Chiari syndrome and in the follow up of patients after definitive therapy. Methodology: Ninety-seven patients with clinically suspected Budd Chiari syndrome underwent color Doppler imaging to identify the site and cause for obstruction, flow across the obstructed segment of the hepatic veins and / or inferior vena cava and to identify the collateral pathways of hepatic venous drainage. Sixty-two patients were subjected to angiography and Doppler - angiography correlation was also studied. Results: Seventy one out of the ninety seven patients screened had Doppler evidence of Budd Chiari syndrome. 23.94%, 18.30%, 57.74% had type I, type II and type III Budd chiari syndrome respectively. Intrahepatic "comma" collaterals and inferior right hepatic vein were the major collaterals identified in patients with type I and type III disease. Doppler correlated with angiogram in 56 out of 62 patients (90.3%). Conclusion: Color Doppler imaging is an excellent technique for qualitative data on flow direction and pattern, thereby contributing significantly to the diagnosis. It is the choice of investigation in the initial evaluation of patients with suspected primary Budd Chiari Syndrome. It is also recommended as a prime imaging procedure to determine alternative venous pathways, stent and vessel patency following intervention. (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 20, No 3 (2007) (EN)

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