The characteristic of a splanchnic blood-groove at patients with the compensated and decompensated course of cirrhosis

Authors

  • A. S. Tugushev Zaporizhzhia State Medical University,
  • N. V. Tumanska Zaporizhzhia State Medical University,
  • S. M. Gulevsky Training-Scientific Center “University Clinic”,
  • D. I. Mikhantyev SD «Local Clinical Hospital on the Station Zaporizhzhia-2 of the Pridneprovska Railway»,
  • V. V. Neshta SD «Local Clinical Hospital on the Station Zaporizhzhia-2 of the Pridneprovska Railway»,

DOI:

https://doi.org/10.14739/2409-2932.2015.3.52681

Keywords:

Сirrhosis, Splanchnic Blood-Groove, Ultrasonic Scanning, Ultrasonic Dopplerography

Abstract

Syndrome of portal hypertension in liver cirrhosis is determined pathogenetically by the disparity of reduced hepatic portal perfusion to the increase of flowing blood volume. The role of visceral blood flow, which determines the amount of portal blood, is not valued enough.

Aim. The results of survey of 190 patients with liver cirrhosis have been studied in order to assess visceral blood flow.

Methods and results. We have analyzed the clinical condition of patients, the ultrasound scan and Doppler ultrasound results, which characterize the blood flow in the portal, splenic and superior mesenteric vein, hepatic, splenic and superior mesenteric arteries. It was found that the splanchnic blood flow in liver cirrhosis is characterized by an increase in volume portal blood. The natural history of cirrhosis of the liver is accompanied by a decrease in portal blood flow relative to splenic and superior mesenteric flow in the transition from compensated to decompensated state.

Conclusions. This indicates the decrease in hepatic portal perfusion relative to increase in visceral blood volume, an increase of portal pressure portacaval gradient, being one of the causes of hemodynamic complications.

 

References

Abrahamovych, О. О., Dovgan Yu. P., Ferko, М. R., Abrahamovych, М. О., & Tolopko, S. Ya. (2013). Ultrazvukova dopplerofloumetrychna diahnostyka syndromu portalnoi hipertenzii u khvorykh na tsyroz pechinky ta znachennia yii pokaznykiv dlia prohnozu [The ultrasonic Doppler flowmetry for the diagnosis of portal hypertension syndrome in patients with liver cirrhosis and its prognostic value]. Suchasna hastroenterolohіia, 3(71), 45–50. [in Ukrainian].

Garbuzenko, D. V. (2012). Metody prognozirovaniya riska i monitoring e′ffektivnosti terapii krovotechenij iz varikozno-rasshirennykh ven pishhevoda u bol'nykh cirrozom pecheni [Methods of risk prediction and monitoring the effectiveness of therapy of bleeding from varices of the esophagus in patients with cirrhosis]. Rossijskij zhurnal gastroe′nterologii, gepatologii, koloproktologii, 2, 36–44. [in Russian].

Rykhtik, P. I. (2007). Kompleksnaya ul'trazvukovaya ocenka regionarnogo krovotoka pri portal'noj gipertenzii i ee prognosticheskoe znachenie dlya portosistemnogo shuntirovaniya (Avtoref. dis…kand. med. nauk). [A complex ultrasonic assessment of a regionarny blood-groove at portal hypertensia and its pro-gnostic value for portosistemny shunting]. (Extended abstract of candidate’s thesis). Nizhny Novgorod. [in Russian].

Sherlok, Sh., & Dooley, J. (2002). Zabolevaniya pecheni i zhelchnykh putej: prakticheskoe rukovodstvo [Diseases of the liver and biliary system]. Moscow: GEOTAR-MED. [in Russian].

Baik, S. K. (2010). Haemodynamic evaluation by Doppler ultrasonography in patients with portal hypertension: a review. Liver International, 30(10), 1403–1413. doi: 10.1111/j.1478-3231.2010.02326.x.

Colecchia, A., Colli, A., Casazza, G., Mandolesi, D., Schiumerini, R., Reggiani, L. B., et. al. (2014). Spleen stiffness measurement can predict clinical complications in compensated HCV-related cirrhosis: A prospective study. Journal of Hepatology, 60(6), 1158–1164. doi: 10.1016/j.jhep.2014.02.024.

Furuichi, Y., Moriyasu, F., Sugimoto, K., Taira, J., Sano, T., Miyata, Y., et. al (2013). Obliteration of gastric varices improves the arrival time of ultrasound contrast agents in hepatic artery and vein. Journal of Gastroenterology and Hepatology, 28(9), 1526–1531. doi: 10.1111/jgh.12234.

Garcia-Pagan, J.C., Gracia-Sancho, J., & Bosch, J. (2012). Functional aspects on the pathophysiology of portal hypertension in cirrhosis. J Hepatology, 57(2), 458–461. doi: 10.1016/j.jhep.2012.03.007.

Iwakiri, Y., Shah, V., & Rockey, D. C. (2014). Vascular pathobiology in chronic liver disease and cirrhosis – Current status and future directions. Journal of Hepatology, 61(4), 912–924. doi: 10.1016/j.jhep.2014.05.047.

Kaur, S., & Anita, K. (2013) Angiogenesis in liver regeneration and fibrosis: «a double-edged sword». Hepatol Int., 7(4), 959–968. doi: 10.1007/s12072-013-9483-7. E

Kim, M. Y., Jeong, W. K., & Baik, S. K. (2014). Invasive and non-invasive diagnosis of cirrhosis and portal hypertension. World Journal of Gastroenterology, 20(15), 4300–4315. doi: 10.3748/wjg.v20.i15.4300.

Mehta, G., Gustot, Th., Mookerjee, R. P., Garcia-Pagan, J. C., Fallon, M. B., Shah, V. H., et al. (2014). Inflammation and portal hypertension – The undiscovered country. J Hepatology, 61(1), 155–163. doi: 10.1016/j.jhep.2014.03.014.

Prin, M., Bakker, J., & Wagener, G. (2015). Hepatosplanchnic circulation in cirrhosis and sepsis. World Journal of Gastroenterology, 21(9), 2582–2592. doi: 10.3748/wjg.v21.i9.2582.

Yang, Y.-Y., Liu, R.-S., Lee, P.-C., Yeh, Y. C., Huang, Y. T., Lee, W. P., et. al. (2014). Anti-VEGFR agents ameliorate hepatic venous dysregulation/microcirculatory dysfunction, splanchnic venous pooling and ascites of NASH-cirrhotic rat. Liver International, 34(4), 521–534. doi: 10.1111/liv.12299.

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1.
Tugushev AS, Tumanska NV, Gulevsky SM, Mikhantyev DI, Neshta VV. The characteristic of a splanchnic blood-groove at patients with the compensated and decompensated course of cirrhosis. Current issues in pharmacy and medicine: science and practice [Internet]. 2015Nov.3 [cited 2024Nov.23];(3). Available from: http://pharmed.zsmu.edu.ua/article/view/52681

Issue

No. 3 (2015)

Section

Original research

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