INTRASPLENIC VENOUS FLOW PATTERNS DEMONSTRATED BY DOPPLER ULTRASOUND IN PATIENTS WITH PORTAL-HYPERTENSION

The flow pattern in the splenic vein has been previously reported in p atients with portal hypertension, but with no reference to the flow wi thin the intrasplenic venous radicles. Using Doppler ultrasound, this study describes the intrasplenic venous flow direction in 176 adult pa tients with intrahepatic portal hypertension. In our series, a normal flow pattern was maintained in all except four patients (2.3%) who had either reversed or dual venous drainage patterns resulting in trans-s plenic portosystemic shunts, These abnormal patterns are Doppler signs of portal hypertension which might be associated with a higher risk o f oesophageal variceal bleeding. It is recommended that the intrasplen ic venous flow pattern should be assessed before surgical intervention involving the spleen in patients with portal hypertension.