Polish Ultrasound Society (Polskie Towarzystwo Ultrasonograficzne)
Subject: Medicine
ISSN: 2084-8404
eISSN: 2451-070X
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Joanna Ścieszka * / Józefa Dąbek / Paweł Cieślik
Keywords : portal system, Doppler method, constrictive pericarditis
Citation Information : Journal of Ultrasonography. Volume 15, Issue 61, Pages 227-230, DOI: https://doi.org/10.15557/JoU.2015.0019
License : (CC BY-SA 4.0)
Received Date : 17-November-2014 / Accepted: 10-February-2015 / Published Online: 13-September-2016
We report a case of a 17-year-old patient referred to our outpatient Doppler Department due to clinical suspicion of liver cirrhosis. The patient presented with non-specifi c symptoms,such as malaise, pain in the right subcostal region, peripheral oedema. Until then,diagnostic imaging, including echocardiography was inconclusive. We performed the Doppler sonography of the portal system, which revealed normal diameter of the portal vein with abnormal, phasic and markedly pulsatile waveform. Hepatic veins distention with pathological reverse fl ow during systole was reported. Additionally, inferior vena cava was dilated and remained unchanged through the respiratory cycle. Basing on the above image a heart disease, which had not been taken into differential diagnosis before, was suggested. The following echocardiography, together with computed tomography, enabled a diagnosis of constrictive pericarditis. Successful pericardiotomy was performed. Such a complicated diagnostics happened to demonstrate an uncommon example of the use of portal vein waveform in making the proper cardiologic diagnosis
1. Ścieszka J: Znaczenie sonografi i dopplerowskiej w diagnostyce nadciśnienia wrotnego o różnej etiologii. Rozprawa habilitacyjna. Katowice,1997.
2. Abu-Yousef MM, Milam SG, Farner RM: Pulsatile portal vein flow:a sign of tricuspid regurgitation on Doppler duplex sonography. AJR Am J Roentgenol 1990; 155: 785–788.
3. Görg C, Wollenberg B, Beyer J: Reversed portal vein pulsatility on Doppler ultrasound secondary to an iatrogenic mediastinal haematoma. Br J Radiol 2001; 74: 962–964.
4. Bathla G, Singh S, Khandelwal G, Maller V: Pulsatile portal vein sign –an indication of underlying tricuspid regurgitation with congestive failure.The Internet Journal of Radiol 2008; 9.
5. Gallix BP, Taourel P, Dauzat M, Bruel JM, Lafortune M: Flow pulsatility in the portal venous system: a study of Doppler sonography in healthy adults. AJR Am J Roentgenol 1997; 169: 141–144.