Postprandial splanchnic hemodynamic response in patients with cirrhosis of the liver: evaluation with "triple-vessel" duplex US.

PURPOSE

To investigate the effect of a meal on splanchnic circulation in patients with cirrhosis of the liver.

MATERIALS AND METHODS

Ten adult patients with cirrhosis and 10 adult control subjects (mean age, 54 years) underwent duplex ultrasonography. Flow volumes of the portal vein, superior mesenteric artery, splenic artery, and collateral vessels (difference between the splanchnic inflow [the sum of the superior mesenteric arterial and the splenic arterial blood flows] and the portal venous blood flow) were measured before and after a meal every 15 minutes for 60 minutes. Integrated post-prandial changes (the sum of the changes at each time point) were also calculated.

RESULTS

Portal venous blood flow increased after the meal in control subjects (P < .01) and patients (P < .01). The integrated postprandial change in the portal venous blood flow was lower in patients than in control subjects (P < .05). Superior mesenteric arterial blood flow increased after the meal in control subjects (P < .01) and patients (P < .01); the integrated postprandial change in the superior mesenteric arterial blood flow was similar. In the two groups, splenic arterial blood flow remained unchanged after the meal. Collateral blood flow increased after the meal in patients (P < .01).

CONCLUSION

Postprandial portal hyperemia is mainly due to mesenteric arterial vasodilation; reduced postprandial portal hyperemia in patients with cirrhosis is attributable to portocollateral runoff.