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Volume 4 No. 2, April 2009 |
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The Color Doppler Study on the Superior Mesenteric Artery and Femoral Artery in Cirrhotic Patients Abeer S. Ghobashy, Faten M. Salem, Mahmoud Dawoud & Mohammed El-Refaey
Radiodiagnosis & Imaging Department, Faculty of Medicine Tanta
University, Egypt
Aim: is to demonstrate the changes in the Doppler
ultrasonography of splanchnic (superior mesenteric artery) and
extra-splanchnic circulation (Femoral artery) in patients with
cirrhosis. Patient & Methods: The study was conducted on 20 cases as
control and 56 patients, classified according to Child-Paugh (n.65)
grading into 3 groups. The age of the patients ranged from 39 to 52
years, all cases were subjected to history taking clinical
examination, complete liver functions tests, abdominal
ultrasonography, and Doppler study for superior mesenteric and
femoral arteries. Data from the Doppler study were analyzed to
calculate the mean blood flow and the pulsatility index of the
superior mesenteric and femoral arteries in different groups.
Results: The results show a significantly higher superior mesenteric
artery blood flow in each Child group than in control group. In
addition, the superior mesenteric artery pulsatility index was
significantly lower in each Child group than in control group. The
study gives evidence, through superior mesenteric artery pulsatility
index, that the primary site of the arterial vasodilatation in human
cirrhosis occurs in splanchnic arterial circulation. Regarding
femoral artery as an extra-splanchnic sample, the study shows a
significant increase in the blood flow in grade B patients, with
significantly lower pulsatility index in the same sample, the
pulsatility index of femoral artery was also significantly lower in
grade A patients than in control group. Conclusion: Doppler study
has an important role to understand the vascular hemodynamics in the
patients with cirrhosis; it is also valuable to recognize the degree
of liver dysfunction. As many drugs are used in cases of cirrhosis
with portal hypertension like B-blockers which affect the splanchnic
hemodynamics, Doppler study and follow up is useful to minitor the
response to treatment and to adjust the dose of medication. Finally
this study depicts the role of extrasplancine arterial circulation
in arterial pressure haemostatic response in the patients with
severs cirrhosis. |
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