Jc. Letard et al., REVERSAL OF PORTAL BLOOD-FLOW IN CIRRHOSI S - CLINICAL, ENDOSCOPIC AND ENDOSONOGRAPHIC CORRELATIONS IN 72 PATIENTS, Gastroenterologie clinique et biologique, 17(8-9), 1993, pp. 578-583
From January to December 1991, the portal venous system was evaluated
by Doppler ultrasonography in 72 patients with liver cirrhosis. The ob
jectives of this study were to evaluate the prevalence of spontaneous
reversal of blood flow in the portal vein and to assess the relationsh
ip between Doppler ultrasound investigation and clinical, biochemical,
endoscopic (70 patients), and endosonographic (44 patients) features.
Reversed flow was quite frequent (alternating: 17 %, permanent: 22 %)
and its prevalence did not differ in relation to age, sex, serum gamm
aglobulin concentration and Child-Pugh class. In patients with reverse
d portal venous flow, the prevalence of hepatic encephalopathy was hig
her (39 % vs 13.5 %, P < 0.05), but the prevalence of esophageal or ga
stric varices was not related to that pattern. Endosonography detected
gastric wall abnormalities in a higher proportion of patients with re
versed portal flow than in patients without it (P < 0.05). This study
suggests that reversal of flow in the portal vein could play a role in
the development of the gastric wall abnormalities in liver cirrhosis,
which are detected by endosonography but not by endoscopy.