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. 1996 Apr;223(4):370–376. doi: 10.1097/00000658-199604000-00005

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

K Nishihara 1, T Yagyu 1, K Sakata 1, K Nakashima 1, T Suzuki 1
PMCID: PMC1235132  PMID: 8633915

Abstract

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bolondi L., Gaiani S., Li Bassi S., Zironi G., Bonino F., Brunetto M., Barbara L. Diagnosis of Budd-Chiari syndrome by pulsed Doppler ultrasound. Gastroenterology. 1991 May;100(5 Pt 1):1324–1331. [PubMed] [Google Scholar]
  2. Bookstein J. J., Cho K. J., Davis G. B., Dail D. Arterioportal communications: observations and hypotheses concerning transsinusoidal and transvasal types. Radiology. 1982 Mar;142(3):581–590. doi: 10.1148/radiology.142.3.7063671. [DOI] [PubMed] [Google Scholar]
  3. Brown B. P., Abu-Yousef M., Farner R., LaBrecque D., Gingrich R. Doppler sonography: a noninvasive method for evaluation of hepatic venocclusive disease. AJR Am J Roentgenol. 1990 Apr;154(4):721–724. doi: 10.2214/ajr.154.4.2107664. [DOI] [PubMed] [Google Scholar]
  4. Deutsch V., Adar R., Bogokowsky H., Itzchak Y., Mozes M. Diversion of the hepatic arterial flow into the portal vein in the Budd-Chiari syndrome. Blood Vessels. 1974;11(1-2):96–100. doi: 10.1159/000158003. [DOI] [PubMed] [Google Scholar]
  5. FERGUSON D. J. HEMODYNAMICS IN SURGERY FOR PORTAL HYPERTENSION. Ann Surg. 1963 Sep;158:383–386. doi: 10.1097/00000658-196309000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Foster D. N., Herlinger H., Miloszewski K. J., Losowsky M. S. Hepatofugal portal blood flow in hepatic cirrhosis. Ann Surg. 1978 Feb;187(2):179–182. doi: 10.1097/00000658-197802000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Grant E. G., Perrella R., Tessler F. N., Lois J., Busuttil R. Budd-Chiari syndrome: the results of duplex and color Doppler imaging. AJR Am J Roentgenol. 1989 Feb;152(2):377–381. doi: 10.2214/ajr.152.2.377. [DOI] [PubMed] [Google Scholar]
  8. Itzchak Y., Adar R., Bogokowski H., Mozes M., Deutsch V. Intrahepatic arterial portal communications: angiographic study. Am J Roentgenol Radium Ther Nucl Med. 1974 Jun;121(2):384–387. doi: 10.2214/ajr.121.2.384. [DOI] [PubMed] [Google Scholar]
  9. Kawasaki T., Moriyasu F., Nishida O., Ban N., Nakamura T., Tamada T., Kimura T., Yamashita Y., Ono S., Uchino H. Analysis of hepatofugal flow in portal venous system using ultrasonic Doppler duplex system. Am J Gastroenterol. 1989 Aug;84(8):937–941. [PubMed] [Google Scholar]
  10. Kessler R. E., Tice D. A., Zimmon D. S. Retrograde flow of portal vein blood in patients with cirrhosis. Radiology. 1969 Apr;92(5):1038–1042. doi: 10.1148/92.5.1038. [DOI] [PubMed] [Google Scholar]
  11. Lafortune M., Patriquin H., Pomier G., Huet P. M., Weber A., Lavoie P., Blanchard H., Breton G. Hemodynamic changes in portal circulation after portosystemic shunts: use of duplex sonography in 43 patients. AJR Am J Roentgenol. 1987 Oct;149(4):701–706. doi: 10.2214/ajr.149.4.701. [DOI] [PubMed] [Google Scholar]
  12. Nelson R. C., Lovett K. E., Chezmar J. L., Moyers J. H., Torres W. E., Murphy F. B., Bernardino M. E. Comparison of pulsed Doppler sonography and angiography in patients with portal hypertension. AJR Am J Roentgenol. 1987 Jul;149(1):77–81. doi: 10.2214/ajr.149.1.77. [DOI] [PubMed] [Google Scholar]
  13. Nishihara K., Sakata K., Yagyu T., Nakashima K., Suzuki T. Relationship between peripheral portal blood flow and liver function in patients with liver cirrhosis. Pulsed Doppler ultrasonographic study. Scand J Gastroenterol. 1994 Sep;29(9):859–864. doi: 10.3109/00365529409092524. [DOI] [PubMed] [Google Scholar]
  14. Ohnishi K., Saito M., Sato S., Nakayama T., Takashi M., Iida S., Nomura F., Koen H., Okuda K. Direction of splenic venous flow assessed by pulsed Doppler flowmetry in patients with a large splenorenal shunt. Relation to spontaneous hepatic encephalopathy. Gastroenterology. 1985 Jul;89(1):180–185. doi: 10.1016/0016-5085(85)90760-7. [DOI] [PubMed] [Google Scholar]
  15. Okuda K., Moriyama M., Yasumoto M., Jinnouchi S., Shimokawa Y. Roentgenologic demonstration of spontaneous reversal of portal blood flow in cirrhosis and primary carcinoma of the liver. Am J Roentgenol Radium Ther Nucl Med. 1973 Oct;119(2):419–428. doi: 10.2214/ajr.119.2.419. [DOI] [PubMed] [Google Scholar]
  16. Okuda K., Musha H., Yoshida T., Kanda Y., Yamazaki T. Demonstration of growing casts of hepatocellular carcinoma in the portal vein by celiac angiography: The thread and streaks sign. Radiology. 1975 Nov;117(2):303–309. doi: 10.1148/117.2.303. [DOI] [PubMed] [Google Scholar]
  17. Ozaki C. F., Anderson J. C., Lieberman R. P., Rikkers L. F. Duplex ultrasonography as a noninvasive technique for assessing portal hemodynamics. Am J Surg. 1988 Jan;155(1):70–75. doi: 10.1016/s0002-9610(88)80260-5. [DOI] [PubMed] [Google Scholar]
  18. Patriquin H., Lafortune M., Burns P. N., Dauzat M. Duplex Doppler examination in portal hypertension: technique and anatomy. AJR Am J Roentgenol. 1987 Jul;149(1):71–76. doi: 10.2214/ajr.149.1.71. [DOI] [PubMed] [Google Scholar]
  19. Price J. B., Jr, Voorhees A. B., Jr, Britton R. C. Operative hemodynamic studies in portal hypertension. Significance and limitations. Arch Surg. 1967 Nov;95(5):843–852. doi: 10.1001/archsurg.1967.01330170151019. [DOI] [PubMed] [Google Scholar]
  20. Rice S., Lee K. P., Johnson M. B., Korula J., Ralls P. W. Portal venous system after portosystemic shunts or endoscopic sclerotherapy: evaluation with Doppler sonography. AJR Am J Roentgenol. 1991 Jan;156(1):85–89. doi: 10.2214/ajr.156.1.1898575. [DOI] [PubMed] [Google Scholar]
  21. Sommer D. G., Greenway G. D., Bookstein J. J., Orloff M. J. Hepatic rupture with toxemia of pregnancy: angiographic diagnosis. AJR Am J Roentgenol. 1979 Mar;132(3):455–456. doi: 10.2214/ajr.132.3.455. [DOI] [PubMed] [Google Scholar]
  22. Takayasu K., Takashi M., Musha H., Ohnishi K., Omata M., Kobayashi C., Okuda K. Spontaneous reversal of portal blood flow demonstrated by percutaneous transhepatic catheterization: report of two cases. Gastroenterology. 1982 Apr;82(4):753–757. [PubMed] [Google Scholar]
  23. WARREN W. D., MULLER W. H., Jr A clarification of some hemodynamic changes in cirrhosis and their surgical significance. Ann Surg. 1959 Sep;150:413–427. doi: 10.1097/00000658-195909000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Winograd J., Palubinskas A. J. Arterial-portal venous shunting in cavernous hemangioma of the liver. Radiology. 1977 Feb;122(2):331–332. doi: 10.1148/122.2.331. [DOI] [PubMed] [Google Scholar]

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