Changes in portal venous hemodynamics in patients with severe acute hepatitis over one year

Purpose. A wide range of portal vein blood flow velocity (PVV) va lues can be found in acute hepatitis. We studied course and medical significance of PVV changes in patients with severe acute hepatitis over a 1-year period. Methods. Portal venous hemodynamics were studied by Doppler sonography in 9 0 patients at study enrollment and 3, 6, and 12 months following an episode of severe acute hepatitis. Results. Forty-one survivors who had a maximum PVV at enrollment greater th an or equal to the value measured at the third month were classified as the "declining PVV" group. Thirty-six survivors who had a maximum PVV at enrol lment less than the value measured at the third month were classified as th e "rising PVV" group. Thirteen patients died of acute hepatic failure and w ere classified as the fatality group. The fatality group had significantly lower maximum PVV, worse liver biochemical test results, and a higher preva lence of ascites at enrollment. In contrast, the declining PVV group showed significantly better liver biochemical test results and a lower prevalence of ascites. There was no significant difference in portal vein blood flow between the rising and declining PVV groups since portal vein diameter incr eased while PVV decreased. Conclusions. An initially decreased PVV can be found in, some patients with severe acute hepatitis and is inversely correlated with the severity of li ver damage. (C) 2000 John Wiley & Sons, Inc.