Barakat M, Hassan A, Soliman A, Nafeh M
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt.
Br J Radiol. 1998 Apr;71(844):384-7. doi: 10.1259/bjr.71.844.9659131.
The flow pattern in the splenic vein has been previously reported in patients with portal hypertension, but with no reference to the flow within the intrasplenic venous radicles. Using Doppler ultrasound, this study describes the intrasplenic venous flow direction in 176 adult patients with intrahepatic portal hypertension. In our series, a normal flow pattern was maintained in all except four patients (2.3%) who had either reversed or dual venous drainage patterns resulting in trans-splenic portosystemic shunts. These abnormal patterns are Doppler signs of portal hypertension which might be associated with a higher risk of oesophageal variceal bleeding. It is recommended that the intrasplenic venous flow pattern should be assessed before surgical intervention involving the spleen in patients with portal hypertension.
此前已有关于门静脉高压患者脾静脉血流模式的报道，但未涉及脾内静脉分支内的血流情况。本研究利用多普勒超声描述了176例肝内门静脉高压成年患者的脾内静脉血流方向。在我们的研究系列中，除4例患者（2.3%）外，其余患者均维持正常血流模式，这4例患者存在反向或双静脉引流模式，导致经脾门体分流。这些异常模式是门静脉高压的多普勒征象，可能与食管静脉曲张出血的较高风险相关。建议在对门静脉高压患者进行涉及脾脏的手术干预前，评估脾内静脉血流模式。
