[
Abstract]
[
Full Text PDF] （in Japanese / 2623KB）
[Members Only And Two Factor Auth.] J.Jpn. Surg. Soc.. 96(2): 106-115, 1995
Original article
TRANSENDOSCOPIC MICROVASCULAR DOPPLER SONOGRAPHY FOR THE ASSESSMENT OF HEMODYNAMICS OF ESOPHAGEAL AND GASTRIC VARICES
The importance to unravel hemodynamics at the stomach and esophagus in patients with portal hypertension has been described for understanding pathophysiology and treatment of varices associaed with portal hypertension. Microvascular Doppler sonogrlaphy (MF20) is a pulse Doppler method with 20 MHz which is able to measure velocity and direction of blood flow in microvessesl. We invented transendoscopic microvascular Doppler sonography (EMDS) by connecting a tiny probe of one mm in diameter with an endoscopy. We evaluated direction of blood flow in the esophageal and gastric varices by EMDS and angiography in 21 untreated and 26 shunt-operated patients with portal hypertension. In all of untreated patients direction of blood flow in the varices was toward the probe (forward). Results obtained with EMDS were consistent with angiographic results available in 13 patients. Direction of blood flow after shunt operation was away from the probe in 21 out of 26 patients. The comparison with angiography revealed that post-operative patients with “away" blood flow in varices had maintained satisfactory shunt selectivity without hepatofugal collateral and it proved that the direction of blood fiow was toward the shunt at lower pressure. In conclusion EMDS is useful as an evaluation method for hemodynamics in varices of the esophagus and stomach.
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