Clinical characteristics of portal hemodynamics in alcoholic liver cirrhosis.
BACKGROUND
Low incidence of reversal blood flow at the portal vein has been reported by measurement in larger and extrahepatic blood vessels but not in intrahepatic blood vessels in patients with liver cirrhosis. Moreover, there is little information regarding the incidence of reversal blood on the basis of the cause of liver cirrhosis. The aim of this study was to measure the reversal blood flow in the portal vein including intrahepatic branches in patients with alcoholic and viral cirrhosis.


METHODS
The blood flow in the portal vein and existence of portosystemic shunt were studied in 52 and 27 patients with alcoholic and viral cirrhosis, respectively, by Doppler ultrasonography. The parameters of liver function test and the prevalence of ascites and esophageal varices were compared between patients with and without reversal blood flow.


RESULTS
Reversal blood flow at the portal vein was found only in patients with only alcoholic cirrhosis (17 of 52 patients) but not in any patients with viral cirrhosis (0 of 27 patients; p < 0.05). The incidence of portosystemic ascites and red color of esophageal varices was also higher in patients with alcoholic cirrhosis with reversal blood flow in the portal vein compared with patients without reversal blood flow (p < 0.05).


CONCLUSIONS
Reversal blood flow in the portal vein is a characteristic feature of alcoholic cirrhosis. The presence of reversal blood flow indicates severe liver diseases, and this feature may have prognostic importance for patients with alcoholic cirrhosis.
Department of Internal Medicine, Matsuyama Joto Hospital Matsuyama, Rhime, Japan. majohp07@mail.netwave.or.jp
Mami
M
Hirata
Kiyotaka
K
Kurose
Hisaka
H
Minami
Teru
T
Kumagi
S M Fazle
SM
Akbar
Koujirou
K
Michitaka
Norio
N
Horiike
Morikazu
M
Onji
D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000502:physiology; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000502:physiology; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000502:physiology*; D012039:Regional Blood Flow / Q000502:physiology; D018615:Ultrasonography, Doppler, Color / Q000379:methods