Objectives: To compare grayscale and color Doppler ultrasound (CDUS) findings to that of multidetector computed tomography (MDCT) portography in the evaluation of portal hypertension in children.
Methods: Thirty children (mean age, 11.4 years) with definitive clinical and laboratory diagnoses of portal hypertension were included in the study. Liver parenchymal changes, portal vein thrombosis, cavernous transformation, splenomegaly, recanalization of the paraumbilical vein, ascites collateral vessels, and hemodynamic parameters were evaluated prospectively.
Results: Liver parenchymal heterogeneity (n = 21) was detected more often by CDUS than MDCT (P = 0.002). CDUS and MDCT established similar results for increased right/left lobe ratio, lobulation of the liver contour, ascites, and splenomegaly. Portal vein thrombosis, cavernous transformation, and recanalization of the paraumbilical vein were comparable between CDUS and MDCT (κ = 1, P < 0.01). Collaterals were detected more by MDCT portography than by CDUS. Esophageal collaterals and azygous vein dilatation were seen only by MDCT portography (P < 0.01, P = 0.024; respectively).
Conclusions: CDUS was superior to MDCT in identifying parenchymal changes and hemodynamic parameters. MDCT was superior in detecting abnormal collateral circulation. The combination of these two modalities provides more comprehensive information than either alone in the diagnosis and follow-up of portal hypertension.
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BMJ Case Rep
January 2025
Radiodiagnosis and Interventional Radiology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
Budd-Chiari syndrome with obstruction in the inferior vena cava causes increased venous pressure in the azygous-hemiazygous system and paravertebral venous plexus, which is transmitted to the epidural venous plexus, devoid of the valves. It causes epidural venous plexus engorgement and venous congestion and may present rarely with low back pain or radiating pain. However, patients developing lower limb weakness as a complication of Budd-Chiari syndrome is an infrequent and severe presentation.
View Article and Find Full Text PDFArab J Gastroenterol
January 2025
Department of Radiology, West China Hospital, Sichuan University, Chengdu, PR China. Electronic address:
Congenital extrahepatic portosystemic shunt, also known as Abernethy malformation, is a rare anatomic vascular malformation. Patients with Abernethy malformation may present with abdominal pain, abnormal liver function tests, hepatopulmonary syndrome, pulmonary hypertension, and/or portosystemic encephalopathy. Accurate identification of the shunt and portal vein and effective management of complications is vital in these patients.
View Article and Find Full Text PDFActa Gastroenterol Belg
January 2025
Department of gastroenterology, Ghent University Hospital, Ghent, Belgium.
Acute gastric variceal bleeding is a rare but serious complication of portal hypertension. Initial therapy for bleeding gastric varices focuses on acute hemostasis. In this regard, endoscopic cyanoacrylate injection (ECI) is the first-line approach.
View Article and Find Full Text PDFPulm Circ
January 2025
Division of Pulmonary Medicine, Henry Ford Hospital Detroit Michigan USA.
Common variable immunodeficiency (CVID) is a type of primary immunodeficiency that presents as a heterogenous disorder characterized by hypogammaglobinemia, poor response to vaccines, recurrent sinopulmonary infections, and can have noninfectious systemic manifestations. We performed a single-center, retrospective, observational study of five patients with noninfectious complications of CVID. All patients had CVID as defined by the European Society of Immunodeficiencies criteria and had received intravenous immunoglobulin therapy.
View Article and Find Full Text PDFWorld J Hepatol
December 2024
Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece.
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