Echo-Doppler evaluation of reverse flow sign in the intrahepatic portal branches after surgery.

OBJECTIVE

The author's evaluated the clinical significance of the development of reversed portal flow after abdominal surgery other than portosystemic shunt procedure.

SUMMARY BACKGROUND DATA

There have been several reports in regard to reversed portal flow demonstrated by pulsed Doppler ultrasonography, most of which were related to portal hypertension. To the authors' knowledge, this is the first report in which reversed portal flow also is present in patients who have undergone abdominal surgery other than portosystemic shunt procedure.

METHODS

Preoperative and postoperative pulsed Doppler ultrasonographic examinations were performed in 126 patients who underwent abdominal surgery. Postoperatively, the portal flow direction was assessed in the right portal branch or the umbilical portion of the left portal branch.

RESULTS

Of the 126 patients, reversed portal flow developed in 10 after surgery; 9 of them died of liver failure.

CONCLUSIONS

The postoperative development of reversed portal flow is considered to have grave prognostic significance, indicating that the degree of postoperative liver damage is extremely critical.