Presentation on Portal venous doppler

1. Dr S,Krithika

14. PORTAL HYPERTENSION
 Represents increased hydrostatic pressure within the portal
vein and its tributaries
 DEFINITION:
 Increase in the pressure gradient between the portal vein
and hepatic veins or IVC.
 Normal portal venous pressure=5 to 10 mm Hg
 Normal portal vein diameter=10mm inspiration=13mm
 Increases in diameter with deep inspiration.
 Hepatopetal
 Following meal flow increases peaks b/w 30-60min and
normal at 90 min.

15. PORTAL
HYPERTENSION
OBSTRUCTIVE
PREHEPATIC HEPATIC
HYPERKINETIC
POST HEPATIC

16. PREHEPATIC
• PORTAL VEIN
THROMBOSIS
HEPATIC
• PRESINUSOIDAL-
ascariasis
• SINUSOIDAL-
Hepatitis
• Cirrhosis
• POST SINUSOIDAL
• Veno occulusive
disease
POST HEPATIC
• BUDD CHIARI
SYNDROME

17. USG SIGNS
 PORTAL VEIN
DIAMETER>13mm
 PORTAL VEIN
PRESSURE>10mmHg
 PORTAL VEIN
VELOCITY <16mmHg.

36. TAKE HOME POINTS
 Normal portal venous pressure=5 to 10 mm Hg
 Normal portal vein diameter=10mm inspiration=13mm
 Increases in diameter with deep inspiration.
 Hepatopetal
 Following meal flow increases peaks b/w 30-60min
and normal at 90 min.
PORTAL HYPERTENSION:
 PORTAL VEIN DIAMETER>13mm
 PORTAL VEIN PRESSURE>10mmHg
 PORTAL VEIN VELOCITY <16mmHg.

37. TAKE HOME POINTS
CHECKLIST
 Status of the liver,spleen
 Portal vein and splenic vein size
 Portal vein shape
 Respiratory variation
 Dilated sv>10mm
 Loss of phasic variation
 Thrombus
 Dilated hepatic arteries
 DILATED CORONARY vein>6mm
 Direction of flow
 Presence of collaterals