[Portal blood flow studied in children with portal hypertension using Doppler duplex echocardiography].

UNLABELLED

The study of portal morphology and hemodynamics is due the fact that the principle symptoms of portal hypertension are due primarily to alterations in the circulation of the venous portal system. The Doppler duplex echography (bidimensional echography in real time plus pulsatile Doppler) allows one to study these circulatory alterations in a non-invasive manner.

MATERIAL AND METHOD

For these studies, an echograph (Toshiba, model Sonolayer SSH-60A) was used to study the morphology and the blood flow of the portal vein and the hepatic artery in 83 children. These children were divided into 4 groups: a) 9 children with atresia of the biliary ducts, b) 11 children with cavernoma of the portal vessel, c) 5 children with neonatal hepatitis and d) 58 healthy children. The parameters studied included the calibre, cross-sectional area, perimeter, velocity, blood flow volume, index of congestion and fluctuation and the direction of the portal flow, as well as the index of resistance of the hepatic artery.

RESULTS

The results obtained in groups a, b and c were compared to healthy children of the same weight. When compared to normal children, it was found that children with portal hypertension had a decrease in the velocity and volume of the blood flow with respiration. There were no differences in the size of the portal vein nor in the index of resistance of the hepatic artery. The values obtained in children with neonatal hepatitis did not differ from those found in healthy children.

CONCLUSIONS

We conclude that the Doppler duplex echography is an excellent method for the diagnosis and follow-up of portal hypertension, as well as for the detection of this condition early in asymptomatic patients.