Duplex Doppler examination in portal hypertension: technique and anatomy

Three hundred fifty duplex Doppler examinations were performed in 195 patients (150 adults and 45 children) with radiologically and/or clinically proved portal hypertension. In this paper we describe this duplex Doppler technique for the qualitative assessment of splanchnic venous hemodynamics in these patients. The caliber of and the presence and direction of flow in the following veins are assessed: splenic, superior mesenteric, portal and intrahepatic portal, and portasystemic collateral. This examination can be performed on patients of any age without sedation and can establish the diagnosis of clinically significant portal hypertension. Technical success rate was 95%, although 10% of examinations were incomplete because of intestinal meteorism. We conclude that the combined use of Doppler and routine sonography permits precise evaluation of the vascular anatomy in portal venous hypertension.