Ultrasonography in portal hypertension

High resolution real time ultrasound is a non-invasive method of evaluating patients with suspected portal hypertension. The portosystemic collateral most frequently identified is the dilated coronary vein and its associated gastro-oesophageal varices. Other collaterals that can be seen include: gastrorenal, splenorenal, paraduodenal, periportal, pelvic and retroperitoneal varices along with a recanalized umbilical vein and ductus venosus. Using duplex doppler ultrasound, the rate and direction of portal blood flow can be ascertained. Sonography is better than barium studies in assessing whether gastro-oesophageal varices are present, however, it is not as sensitive as endoscopy, laparoscopy or portography.