FACTORS AFFECTING SPLANCHNIC HEMODYNAMICS IN CROHNS-DISEASE - A PROSPECTIVE CONTROLLED-STUDY USING DOPPLER ULTRASOUND

Background-Current knowledge on splanchnic haemodynamics in Crohn's di sease is limited. Aims-To investigate which features of Crohn's diseas e affect splanchnic haemodynamics, and to establish whether portal vei n (PV) and superior mesenteric artery (SMA) blood supply reflects clin ical or biochemical activity of Crohn's disease. Methods-Seventy nine patients with Crohn's disease and 40 controls were evaluated by Dopple r ultrasound (US). The mean velocity of PV and SMA flow, the volume of blood flow of the PV and SA IA, and the resistance index of SMA were studied. A series of clinical, biochemical, and US variables including Crohn's disease activity index, serum C reactive protein concentratio ns, disease duration and its anatomical location, smoking habits, abdo minal complications, and current medical therapy, as well as the maxim um bowel wall thickness as measured by US, were determined. The relati on between PV and SMA blood flow and these variables was assessed by u nivariate and multivariate analysis. Results-Patients with Crohn's dis ease had significantly higher PV and SMA flow and a lower SIMA resista nce index than controls. Stepwise multiple regression analysis identif ied bowel wall thickness and location of the disease as the main predi ctive variables of both PV and SMA blood flow variation, accounting fo r 36% and 45% of their variability, respectively. No relation was foun d between splanchnic haemodynamics and disease activity. Conclusion-A hyperdynamic mesenteric circulation does exist in Crohn's disease; how ever splanchnic blood flow does not reflect the clinical or biochemica l activity of the disease, but seems to be linked more to other Crohn' s disease characteristics, such as maximum bowel thickness and anatomi cal location.