PORTAL-HYPERTENSION AND ESOPHAGEAL-VARICES IN CYSTIC-FIBROSIS - UNRELIABILITY OF ECHO-DOPPLER FLOWMETRY

To investigate the role of echo-Doppler flowmetry in evaluating patien ts with cystic fibrosis and portal hypertension at risk of esophageal varices, we studied 26 subjects divided in 3 groups: 9 with portal hyp ertension and esophageal varices, S with chronic liver disease without varices, and 9 without chronic liver disease. Spleen size, diameter, blood velocity, and flow rate of portal, splenic, and superior mesente ric veins were recorded. In patients without chronic liver disease Dop pler measurements were repeated on 2 different days to assess intraobs erver variability. Significant differences among the three groups were found for mean values of spleen size and diameters of portal, splenic , and superior mesenteric veins. Nevertheless, a considerable overlapp ing of individual data was observed. No differences were observed in m ean hemodynamic measurements, except for blood velocity in portal vein and flow rate in splenic vein. The intraobserver variability for repe ated Doppler measurements was clinically unacceptable for most of the variables studied. Echo-Doppler assessment of splanchnic how seems to be an unreliable tool in the management of cystic fibrosis patients wi th portal hypertension at risk of esophageal varices.