Doppler sonographic diagnosis of severe portal vein pulsatility in constrictive pericarditis: Flow normalization after pericardiectomy
✍ Scribed by Gorka, Tanja S.; Gorka, Waldemar
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 715 KB
- Volume
- 27
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
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.