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{{Portal hypertension}}
{{Portal hypertension}}
{{CMG}}; {{AE}}
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==Overview==
==Overview==
[[Portal]] [[venography]] is useful in evaluating the patency and the caliber of the [[portal vein|portal]] and [[splenic vein]]s.
[[Upper endoscopy]] may be helpful in the [[diagnosis]] of [[Esophageal varices|gasteroesophageal varices]]. Findings on an [[upper endoscopy]] diagnostic of [[esophageal varices]] include visible [[submucosal]] tortuous veins, congested [[veins]] without compression during air [[insufflation]], and grape-like [[Varicose veins|varicose]] veins that may occlude the [[lumen]]. Three dimensional [[portal]] [[venography]] may be helpful in the diagnosis of [[Esophageal varices|gasteroesophageal varices]]. Findings on a [[portal]] [[venography]] diagnostic of [[esophageal varices]] include reverse flow in [[Portocaval anastomoses|porto-systemic shunts]], [[collateral]] [[Vein|veins]] draining into [[Inferior vena cava|inferior vena cava (IVC)]], and other [[collateral]] [[veins]].


Upper gastrointestinal [[endoscopy]] is very reliable. It shows the presence of cherry red spots. [[Proctoscopy]] is useful in cases of rectal varices.
==Other Imaging Findings==
{| align="right"
|[[image:OEV wale.jpg|thumb|300px|Esophageal varices-By Samir, via Wikimedia Commons<ref><"https://commons.wikimedia.org/wiki/File%3AEsophageal_varices_-_wale.jpg">via Wikimedia Commons</ref>]]
|[[image:Gastric Varices.jpg|thumb|350px|Gastric varices-By Jeremias (Own work), via Wikimedia Commons<ref><"https://commons.wikimedia.org/wiki/File%3AGastric_Varices.jpg">via Wikimedia Commons</ref>]]
|-
|[[image:Venography.png|thumb|400px|Venography Source:Open-i<ref>{{cite web |url=https://openi.nlm.nih.gov/detailedresult.php?img=PMC3859884_kjped-56-500-g001&req=4 |title=(A) Angiographic portography revealed portal vein, coro &#124; Open-i |format= |work= |accessdate=}}</ref>]]
|[[image:Portal-vein-anatomy.jpg|thumb|350px|Venography-Case courtesy of Dr Omar Bashir, via radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16761">rID: 16761</ref>]]
|}
=== Upper endoscopy ===
* [[Upper endoscopy]] may be helpful in the [[diagnosis]] of [[Esophageal varices|gasteroesophageal varices]].  
* Findings on an [[upper endoscopy]] diagnostic of [[esophageal varices]] include:<ref name="pmid27324725">{{cite journal| author=Abby Philips C, Sahney A| title=Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place. | journal=Gastroenterol Rep (Oxf) | year= 2016 | volume= 4 | issue= 3 | pages= 186-95 | pmid=27324725 | doi=10.1093/gastro/gow018 | pmc=4976684 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27324725  }}</ref>
** Visible [[submucosal]] tortuous veins 
** Congested [[veins]] without compression during air [[insufflation]]
** Grape-like [[Varicose veins|varicose]] veins that may occlude the [[lumen]]<ref name="pmid8076547">{{cite journal |vauthors=Thakeb F, Salem SA, Abdallah M, el Batanouny M |title=Endoscopic diagnosis of gastric varices |journal=Endoscopy |volume=26 |issue=3 |pages=287–91 |year=1994 |pmid=8076547 |doi=10.1055/s-2007-1008969 |url=}}</ref>
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==Other Imaging Findings==
=== Three dimensional portal venography ===
* Three dimensional [[portal]] [[venography]] may be helpful in the diagnosis of [[Esophageal varices|gasteroesophageal varices]].
* Findings on a [[portal]] [[venography]] diagnostic of [[esophageal varices]] include:<ref name="pmid18373819">{{cite journal| author=Agarwal A, Jain M| title=Multidetector CT portal venography in evaluation of portosystemic collateral vessels. | journal=J Med Imaging Radiat Oncol | year= 2008 | volume= 52 | issue= 1 | pages= 4-9 | pmid=18373819 | doi=10.1111/j.1440-1673.2007.01903.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18373819  }}</ref><ref name="pmid12235335">{{cite journal| author=Kang HK, Jeong YY, Choi JH, Choi S, Chung TW, Seo JJ et al.| title=Three-dimensional multi-detector row CT portal venography in the evaluation of portosystemic collateral vessels in liver cirrhosis. | journal=Radiographics | year= 2002 | volume= 22 | issue= 5 | pages= 1053-61 | pmid=12235335 | doi=10.1148/radiographics.22.5.g02se011053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12235335  }}</ref>
** Reverse flow in [[Portocaval anastomoses|porto-systemic shunts]]
** [[Collateral]] [[Vein|veins]] draining into [[Inferior vena cava|inferior vena cava (IVC)]]
** Other [[collateral]] [[veins]]
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==References==
==References==
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[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Hepatology]]
 
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Up-To-Date]]
[[Category:Radiology]]
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Latest revision as of 14:17, 7 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Upper endoscopy may be helpful in the diagnosis of gasteroesophageal varices. Findings on an upper endoscopy diagnostic of esophageal varices include visible submucosal tortuous veins, congested veins without compression during air insufflation, and grape-like varicose veins that may occlude the lumen. Three dimensional portal venography may be helpful in the diagnosis of gasteroesophageal varices. Findings on a portal venography diagnostic of esophageal varices include reverse flow in porto-systemic shunts, collateral veins draining into inferior vena cava (IVC), and other collateral veins.

Other Imaging Findings

Esophageal varices-By Samir, via Wikimedia Commons[1]
Gastric varices-By Jeremias (Own work), via Wikimedia Commons[2]
Venography Source:Open-i[3]
Venography-Case courtesy of Dr Omar Bashir, via radiopaedia.org[4]

Upper endoscopy









Three dimensional portal venography








References

  1. <"https://commons.wikimedia.org/wiki/File%3AEsophageal_varices_-_wale.jpg">via Wikimedia Commons
  2. <"https://commons.wikimedia.org/wiki/File%3AGastric_Varices.jpg">via Wikimedia Commons
  3. "(A) Angiographic portography revealed portal vein, coro | Open-i".
  4. Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16761">rID: 16761
  5. Abby Philips C, Sahney A (2016). "Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place". Gastroenterol Rep (Oxf). 4 (3): 186–95. doi:10.1093/gastro/gow018. PMC 4976684. PMID 27324725.
  6. Thakeb F, Salem SA, Abdallah M, el Batanouny M (1994). "Endoscopic diagnosis of gastric varices". Endoscopy. 26 (3): 287–91. doi:10.1055/s-2007-1008969. PMID 8076547.
  7. Agarwal A, Jain M (2008). "Multidetector CT portal venography in evaluation of portosystemic collateral vessels". J Med Imaging Radiat Oncol. 52 (1): 4–9. doi:10.1111/j.1440-1673.2007.01903.x. PMID 18373819.
  8. Kang HK, Jeong YY, Choi JH, Choi S, Chung TW, Seo JJ; et al. (2002). "Three-dimensional multi-detector row CT portal venography in the evaluation of portosystemic collateral vessels in liver cirrhosis". Radiographics. 22 (5): 1053–61. doi:10.1148/radiographics.22.5.g02se011053. PMID 12235335.

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