3D-ultrasound diagnosis of portosystemic anastomoses

Introduction: The diagnosis of portal hypertension includes the search for portosystemic collateral beds. Only some of these can be explored with real-time US and Doppler -ultrasound, i.e. the umbilical veins, the splenorenal and splenoparietal collaterals, the left gastric vein and the gastroesophageal plexus. Other collateral vessels may occasionally be identified, at the level of the gastric fundus, near the upper pole of the spleen, in the pancreatic region, or in the pericholecystic area. The hemodynamic patterns of the portosystemic collaterals can help in evaluation of hemorrhage risk. Doppler flowmetry i…