Splenic venous flow exceeding portal venous flow at Doppler sonography: relationship to portosystemic varices.

Journal Article (Journal Article)

OBJECTIVE: The purpose of this study was to determine if the Doppler sonographic finding of hepatopetal flow in the splenic vein that exceeds hepatopetal flow in the portal vein is associated with portosystemic varices. MATERIALS AND METHODS: Sixty-four patients with chronic liver disease were studied retrospectively. In 32 patients, splenic venous flow exceeded portal venous flow (S > P group); in 32 patients, portal venous flow exceeded splenic venous flow (P > S group). All patients were evaluated with Doppler sonography and CT of the upper part of the abdomen. Upper endoscopy was performed within 3 months of sonography in 44 of the 64 patients. RESULTS: In the S > P group, mean splenic volume was significantly larger (p = .02) than in the other group. The prevalence of varices as determined by CT in the esophageal, coronary, and peripancreatic regions was also higher in this group (p < or = .01). When esophageal varices were present, they were judged on the basis of their CT appearance to be massive in 50% of the S > P group and in 0% of the P > S group. Upper endoscopy revealed esophageal varices in 92% of the S > P group and in 55% of the P > S group (p < .005). Bleeding esophageal varices were noted in 75% of the S > P group and in 30% of the P > S group (p < .01). CONCLUSION: Patients with chronic liver disease and the Doppler sonographic finding of splenic venous flow that exceeds portal venous flow have an increased prevalence of portosystemic varices, which tend to be larger and more likely to bleed.

Full Text

Duke Authors

Cited Authors

  • Nelson, RC; Sherbourne, GM; Spencer, HB; Chezmar, JL

Published Date

  • September 1993

Published In

Volume / Issue

  • 161 / 3

Start / End Page

  • 563 - 567

PubMed ID

  • 8352105

International Standard Serial Number (ISSN)

  • 0361-803X

Digital Object Identifier (DOI)

  • 10.2214/ajr.161.3.8352105


  • eng

Conference Location

  • United States