DOPPLER ULTRASOUND EVALUATION OF HEPATIC VENOUS WAVEFORM IN PORTAL HYPERTENSION
Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 1
Abstract
Aim: The purpose of our study was to prospectively evaluate hepatic vein Doppler waveforms and the response to drug treatment in patients with portal hypertension. Materials and Methods: A prospective study of 60 patients with Portal hypertension and variceal bleeding was done. Inclusion criteria : Patients with portal hypertension and recent variceal bleeding. Exclusion criteria: All the patients with 1. Hepato cellular carcinoma 2. Hepatic encephalopathy 3. Thrombosis in IVC, hepatic vein or portal vein 4. Congestive heart failure. All the patients were started with oral propranolol after the initial Doppler ultrasonography. The treatment response was studied with hepatic venous waveform. The patients were evaluated using Doppler ultrasound with a 3.5MHzcurvilinear transducer in ALOKA-3500 . Doppler traces were obtained in the right or middle hepatic vein at a distance of 4 to 5 cms from the junction of the hepatic vein and inferior vena cava. The hepatic vein waveforms are classified as triphasic (reversed flow in atleast one phase), biphasic (no reversed flow) or monophasic (flat and with or without fluttering). Results and Observation : Male Prepondrance was noted due to Alcoholic Liver Disease. The baseline examination shows Triphasic hepatic Venous waveforms in 18 patients. Abnormal biphasic waveforms were seen in 30 patients and monophasic waveforms in 12 patients. All the patients were given Propranolol (PPNL) and follow-up Hepatic venous waveform taken every 15 days. Our study showed 70% of abnormal HV waveforms (biphasic and monophasic) in clinically diagnosed portal hypertension patients.In those abnormal waveform patients 71% showed Biphasic, 29% showed Monophasic (Baseline observations). After PPNL all those Biphasic patients showed triphasic waveforms. In those Monophasic waveform patients, 75% showed improvement either to Biphasic or Triphasic. 25% of Baseline Monophasic patients showed no improvement even after two months followup.
Authors and Affiliations
Surekha G, Kasi visalakshi K. P, Malathi K
Keywords
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