PORTAL BLOOD-FLOW IN ACUTE HEPATITIS WITH AND WITHOUT ASCITES - A NONINVASIVE MEASUREMENT USING AN ULTRASONIC DOPPLER

To evaluate the role of portal blood flow in severe acute hepatitis le ading to the formation of ascites, we studied the portal blood flow of 30 patients with severe acute hepatitis (20 without ascites and 10 wi th ascites), 20 patients with mild acute hepatitis and 20 healthy norm al volunteers using duplex sonography. The portal blood flow of patien ts with severe acute hepatitis and ascites (421 +/- 94 mL/min) was low er than that of the volunteers (725 +/- 131 ml/min), the mild acute he patitis (658 +/- 148 mL/min), and the severe acute hepatitis (633 +/- 108 mL/min) without ascites (P<0.001). The congestion index of severe acute hepatitis and ascites (0.16 +/- 0.04 cm . s) was higher than tha t of the volunteers (0.09 +/- 0.03 cm . s, P < 0.001), the mild acute hepatitis (0.09 +/- 0.02 cm . s, P<0.001), and the severe acute hepati tis (0.12 +/- 0.04 cm . s, P < 0.02) without ascites. Portal blood flo w was negatively correlated with prolonged prothrombin time (P<0.001) and serum total bilirubin level (P=0.002) and congestion index was pos itively correlated with heart rate (P=0.006), prolonged prothrombin ti me (P<0.001) and serum total bilirubin level (P=0.001). Our study show s that in severe acute hepatitis, portal blood flow was reduced in pat ients with ascites. The non-invasive ultrasonic Doppler is a safe and helpful method in the clinical evaluation of portal hypertension in se vere acute hepatitis.