Portal pressure changes induced by medical treatment: US detection

The portal venous system was studied by ultrasonography (US) in 18 patients with cirrhosis of the liver who had previous bleeding from large esophageal varices. Portal-tract pressure for ten of these patients also was measured by hepatic vein catheterization. After 21 days of treatment with atenolol, the calibers of their splanchnic veins decreased during expiration, while a response to breathing maneuvers was restored. The decrease in the caliber of the splenic and superior mesenteric veins seen by US appeared to correlate significantly with the decrease in portal pressure (P less than .05). Nonresponse to treatment also was detected by US. Real-time US may be routinely carried out as a noninvasive, easy-to-repeat technique for the study of portal system hypertension in patients with cirrhosis undergoing therapy with beta-adrenergic blocking agents.