463-126 |Adjacent Portal Vein Collateral with Retrograde Flow-Adjacent Portal Vein Collateral with Retrograde Flow

Adjacent Portal Vein Collateral with Retrograde Flow

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This article presents a case report of a patient with nonalcoholic liver cirrhosis and portal vein hypertension (PVHTN). The patient underwent a duplex ultrasound (DUS) examination with elastography to evaluate the condition. The most significant finding was the presence of a prominent portal vein collateral with retrograde (hepatofugal) flow, which confirmed the diagnosis of PVHTN. Other sonographic findings included a dilated portal vein, splenomegaly, and minimal respiratory variation in the splanchnic vessels. The elastography measurements revealed a liver stiffness suggestive of compensated advanced chronic liver disease. The article discusses the pathophysiology of PVHTN and the importance of detecting and diagnosing spontaneous portosystemic shunts (SPSS) in patients with cirrhosis. While esophago-gastro-duodenoscopy is considered the gold standard for diagnosing gastroesophageal varices, ultrasonography is an excellent tool for demonstrating collateral veins. The article also highlights the technical challenges of DUS scanning in patients with cirrhosis and the parameters to be described as signs of PVHTN. The presence of retrograde flow in a portal vein collateral, along with other Doppler findings, can guide treatment decisions for patients with PVHTN compared to those with compensated cirrhosis. Overall, this case report emphasizes the importance of using ultrasound techniques to detect and confirm the presence of PVHTN and SPSS.

Keywords

nonalcoholic liver cirrhosis

portal vein hypertension

PVHTN

duplex ultrasound examination

elastography

portal vein collateral

retrograde flow

splanchnic vessels

compensated advanced chronic liver disease

spontaneous portosystemic shunts