Evaluation of therapeutic effects on rectal varices using percutaneous color Doppler ultrasonography

We report the usefulness of percutaneous color Doppler ultrasonography (CDU) for evaluating therapeutic effects on rectal varices.

Ultrasonographic examination and color flow imaging were performed using a color Doppler unit (Aplio 50 or XV, Toshiba, Tokyo, Japan) with a 3.5 MHz convex probe. We performed endoscopic injection sclerotherapy (EIS) for rectal varices in seven patients and partial splenic arterial embolization (PSE) for hypersplenism in four. We examined color flow images and measured the velocity of blood flow in rectal varices using fast-Fourier transform analysis by CDU in all eleven patients, before and after treatments.

Rectal varices were detected by Doppler color flow imaging in all eleven patients before treatments. Blood flowvelocity in the rectal varices ranged from 5.7-11.6 cm/s (mean 8.6 cm/s). Rectal varices were observed in all patients by colonoscopy; enlarged, tortuous large varices with red color sign in nine and enlarged, tortuous large varices without red color in two. Seven days after EIS or PSE, CDU showed an extreme decrease in blood flow in all eleven rectal varices, compared to values before EIS or PSE.

CDU can be performed repeatedly and is useful for evaluating the therapeutic effects of treatments for rectal varices.