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Doppler sonographic diagnosis of severe portal vein pulsatility in constrictive pericarditis: Flow normalization after pericardiectomy
Author(s) -
Gorka Tanja S.,
Gorka Waldemar
Publication year - 1999
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/(sici)1097-0096(199902)27:2<84::aid-jcu7>3.0.co;2-b
Subject(s) - medicine , pericardiectomy , constrictive pericarditis , cardiology , portal venous pressure , hemodynamics , doppler echocardiography , radiology , portal hypertension , diastole , blood pressure , cirrhosis
This case report describes the noninvasive assessment of hepatic and portal vein hemodynamics in a patient with constrictive pericarditis before and after pericardiectomy. Doppler sonography of the hepatic veins demonstrated a typical W‐shaped pattern with pronounced late diastolic flow reversal that disappeared after surgery. Preoperatively, we observed severe pulsatility of the portal vein with flow reversal in systole; after pericardiectomy, portal venous flow was normal. We concluded that the high right atrial pressure in this patient might have led to increased hepatic venous outflow resistance, with subsequent trans‐sinusoidal shunting between the hepatic artery and portal vein causing severe portal vein pulsatility. After pericardiectomy and a decrease in right atrial pressure, portal vein flow normalized. © 1999 John Wiley & Sons, Inc. J Clin Ultrasound 27:84–88, 1999.