VALUE OF DOPPLER ULTRASOUND IN PREDICTING ESOPHAGEAL VARIX BLEEDING

Avramovski, Petar and Siljanovski, Simeon and Servini, Zaklina (2008) VALUE OF DOPPLER ULTRASOUND IN PREDICTING ESOPHAGEAL VARIX BLEEDING. MEDICUS, 10 (2). pp. 4-13. ISSN 1409-6366

Text 2. МЕДИКУС, Откривање на крвавење од езофагеални вени.pdf - Published Version Download (497kB)

Abstract

Bleeding from esophageal varices is the most lifethreatening complication of
cirrhosis. The purpose of the study was to elucidate the hemodynamic features of left
gastric veins (LGV) and portal vein (PV) during portal hypertension. We want to
determine value of Color Doppler Ultrasoung detecting esophageal varices (EV) in
different grades of those on upper gastrointestinal endoscopy. We used CDUS to measure
diameter, flow velocity and flow volume of LGV and PV at 60 patients with diagnosed
varices by endoscopy in different stage, because esophageal varices reflect
hemodynamics of the LGV and to evaluate whether these Doppler US parameters might
predict variceal bleeding in patient with portal hypertension. The flow velocity in the
LGV of F0 healthy controls was V=8,27±2,2 cm/s (n = 21), diameter of LGV was
d=2,36±0,2mm and mean flow volume was Vflow =21,7mL/min. The mean portal flow
volume was PFmean=1600mL/min. The flow velocity in the LGV of F1 stage group was
V=8,9±2,7 cm/s (n = 13), diameter of LGV was d=3,4±0,3mm and mean flow volume
was Vflow =48,45mL/min. The mean portal flow volume was PFmean=1430mL/min. The
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flow velocity in the LGV of F2 stage group was V=11,0±2,3 cm/s (n = 15), diameter of
LGV was d=4,1±0,4mm and mean flow volume was Vflow =87,09mL/min. The mean
portal flow volume was PFmean=1275mL/min, and in F3 stage group the parameters
were V=14,1±3,1cm/s (n=18), d=5,4±0,4mm and Vflow =193,6mL/min. PFVmean=975
mL/min. Variceal bleeding was more frequent in F3A stage patients with a hepatofugal
flow velocity >15 cm/s. In that stadium we measured: V=16,3±1,1cm/s (n=20),
d=6,2±0,3mm and Vflow =295,1mL/min and PFVmean=952mL/min. No correlation was
observed between the portal blood flow velocity and EV. There was a relationship
between the percentage changes in LGV flow velocity, diameter of LGV and the size of
varices (P<0,01). Doppler ultrasonography has great value in the identification of patients
with portal hypertension at risk of variceal bleeding. Hemodynamics of the LGV appears
to be superior to those of the PV in predicting bleeding. The ultrasonographic
examination is a simple, inexpensive, accurate, and noninvasive technique and it is useful
tool for predicting esophageal varix bleeding.
Key words: esophageal varices (EV), left gastric vein (LGV), Doppler, varix bleeding,
hemodynamics.

Item Type:	Article
Subjects:	Scientific Fields (Frascati) > Medical and Health Sciences > Clinical medicine
Divisions:	UKLO Network
Depositing User:	UKLO Mrezha
Date Deposited:	27 May 2024 05:57
Last Modified:	27 May 2024 05:57
URI:	https://eprints.uklo.edu.mk/id/eprint/9932

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