Collateral veins in portal hypertension: demonstration by sonography

The diagnostic value of real-time sonography for portal hypertension was assessed in 38 patients with collateral veins using a linear array scanner in comparison with percutaneous transhepatic portography. The frequency of detection of collaterals by sonography relative to that by percutaneous transhepatic portography was 85% for the coronary, 100% for the paraumbilical, and 10% for the short gastric veins. Sonography demonstrated the paraumbilical vein in three patients in whom portography failed to opacify it. Real-time sonography is perhaps the first-choice procedure for the demonstration of collateral veins and diagnosis of portal hypertension.