Portal Duplex Sonography in Liver Cirrhosis: A Useful Supplement to Endoscopic Evaluation of Bleeding Risk of Esophageal Varices?

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BACKGROUND: In a prospective study we investigated whether the endoscopic assessment of the bleeding risk of esophageal varices could be supported by portal duplex sonography. METHODS: Over the time span of 2.5 years (range, 13 +/- 5 months) we observed 41 patients with liver cirrhosis. During that time 17 patients had acute esophageal variceal hemorrhage and constituted the bleeding group, and the remaining 24 patients without a hemorrhage constituted the non-bleeding group. RESULTS: Within the bleeding group the mean portal blood flow velocity (Vm) was 0.093 +/- 0.033 m/sec, and the mean flow volume (Fm) was 0.371 +/- 0.173 l/min. Both results were significantly lower than the corresponding results of the nonbleeding group (p < 0.017; p < 0.05). By assuming cut-offs for Vm of 0.12 m/sec and for Fm of 0.420 l/min, we obtained a diagnostic sensitivity for hemorrhage of 0.88 and 0.65. CONCLUSION: Our results show that portal duplex sonography may improve the evaluation of endoscopically ascertained bleeding risk of esophageal varices.