Color Doppler evaluation of left gastric vein hemodynamics in cirrhosis with portal hypertension and its correlation with esophageal varices and variceal bleed
Subathra Adithan, Bhuvaneswari Venkatesan, Elangovan Sundarajan, Vikram Kate, Raja KalayarasanAim: The purpose of this study is to assess the value of Doppler evaluation of left gastric vein hemodynamics in monitoring portal hypertensive patients by correlating Doppler ultrasound parameters with the severity of esophageal varices and occurrence of variceal bleed.
Methods: This study was carried out in 100 patients by Doppler ultrasound and endoscopy. 47 of these were patients with cirrhosis with portal hypertension who did not have recent variceal bleed (Group 1) and 26 were patients with cirrhosis with portal hypertension with recent history of bleeding (Group 2). Control group comprised of 27 subjects who did not have liver disease or varices on endoscopy (Group 3). Hemodynamic parameters namely the diameter, direction and flow velocity of left gastric vein were compared in these groups and with the grade of esophageal varices.
Results: Hepatofugal flow velocity in the left gastric vein was higher in patients with large sized varices compared to those patients with small sized varices (p<0.001). The left gastric vein hepatofugal flow velocity (p<0.0149) was higher in patients with a recent variceal bleed compared to those patients without a recent history of variceal bleed. Large sized varices were more commonly found in patients with a history of recent variceal bleed. (p<0.0124)
Conclusion: Left gastric vein hemodynamics was found to correlate with the severity of varices and occurrence of recent variceal bleed in patients with cirrhosis with portal hypertension. Evaluation of the left gastric vein portal dynamics can be helpful in monitoring the progress of the disease in these patients."