Portal systemic shunt through the renal vein

Yamada, Mamiko; Ishida, Hideaki; Komatsuda, Tomoya; Furukawa, Kayoko; Yagisawa, Hitoshi; Ohno, Hideo; Katsuura, Yumi; Suganuma, Kazuki

doi:10.1007/s00261-005-8006-y

Cited by 6 publications

(2 citation statements)

References 3 publications

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“…An unstable or varying portal pressure level may produce periodic changes in intravascular pressure differences between the portal vein and the LGV near the cardia of the stomach, which would periodically change the flow direction in the LGV as a to-and-fro waveform. Furthermore, unlike the arterial system, blood flow easily changes in the portal vein system both under normal conditions and under pathological conditions, as is observed in patients with a large portal systemic shunt [9,10]. The mechanisms and clinical implications of these unusual flow patterns in the LGV should be clarified in further studies of portal hypertension in the future.…”

Section: Discussionmentioning

confidence: 91%

To-and-fro waveforms in the left gastric vein in portal hypertension

Matsutani

Mizumoto

2011

J Med Ultrasonics

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Unusual to-and-fro waveforms were demonstrated in the left gastric vein on Doppler sonograms in four patients with liver cirrhosis. The patterns of the to-and-fro waveforms were diverse in each of the patients: both hepatopetal and hepatofugal flow occurred in a single waveform in case 1, changes in the flow direction with flow interruption were noted in case 2, and changes in flow direction without observation of flow interruption and changes after meals were noted in cases 3 and 4, respectively. These waveforms may represent a transitional phase during the development of a portal systemic shunt in patients with portal hypertension.

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Section: Discussionmentioning

confidence: 91%

To-and-fro waveforms in the left gastric vein in portal hypertension

Matsutani

Mizumoto

2011

J Med Ultrasonics

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“…Although maintaining the fi eld of vision during EVL for bleeding duodenal varices can be diffi cult, EVL may be useful for temporary hemostasis. 13,14,19 Nonetheless, rebleeding of duodenal varices is a problem with EVL. Additional treatment is recommended after duodenal varices have been treated with EVL.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of color Doppler ultrasonography for the diagnosis of duodenal varices successfully treated with percutaneous transhepatic obliteration

et al. 2007

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We treated a 74-year-old woman who complained of tarry stool. Neither endoscopic examination of the upper gastrointestinal tract nor colonoscopy revealed any finding indicative of bleeding, and (99m)Tc-HSA-D pool scintigraphic imaging showed no accumulation of blood in the digestive tract. Small tortuous collateral veins were observed on computed tomography (CT) in the distal third portion of the duodenum. Color Doppler ultrasonography obtained color flow images of varices in the distal third portion of the duodenum indicating turbulent flow, and color flow imaging showed the outflow vessel from duodenal varices. Duodenoscopy revealed tortuous varices, with erosions and blue in appearance, in the same area. Percutaneous transhepatic portography was carried out 18 days after the treatment of ascites, and hepatofugal blood flow was confirmed in the pancreatic duodenal vein originating near the junction between the splenic and inferior mesenteric veins with the passage of contrast medium into the duodenal varices, which drained into the left ovarian vein. We performed selective catheterization into the afferent vein of the varices, and injected 8 ml of a 5% solution of ethanolamine oleate containing iopamidol. Microcoil embolization using steel coils was added because the therapeutic effect resulting after the relatively rapid washout of sclerosant was insufficient. CT and color Doppler ultrasonography showed absence of blood flow in the varices 1 week after the therapy. This patient has had no episodes of rebleeding in the 24 months after therapy. Color Doppler ultrasonography was useful in diagnosing this case of duodenal varices and in evaluating therapeutic effect.

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