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Clinical Significance of Patent Paraumbilical Vein in Patients with Liver Cirrhosis

Digestive Diseases and Sciences volume 45, pages 1861–1864 (2000)Cite this article

Abstract

A patent paraumbilical vein (PUV) is a frequent finding in patients with cirrhosis when studied by duplex Doppler ultrasound. There is controversy regarding the clinical significance of this finding. We studied 50 patients with cirrhosis and portal hypertension as evidenced by the demonstration of esophageal varices on endoscopy. All 50 patients were evaluated for a significant PUV (diameter of ≥3 mm) using duplex Doppler sonography. The patients were divided into two groups based on the size of esophageal varices (group A with small varices, N = 30; group B with large varices, N = 20). A significant PUV was seen in 21 (42%) patients. The patients with portosystemic encephalopathy had a significantly greater prevalence of PUV (70%) than those without (32%, P < 0.02). Of the group with large esophageal varices, 6 (30%) had a significant PUV, while in the group with small varices, 15 (50%) had a significant PUV (P > 0.05). In no patient with large varices did the PUV diameter exceed 6 mm, while in as many as six patients with small varices, the PUV diameter exceeded 6 mm. A significantly enlarged PUV seen on duplex Doppler ultrasound in cirrhotics may have important hemodynamic consequences. Besides predisposing the patient to portosystemic encephalopathy, it may also offer some protection against formation of large varices. In particular, a very large patent PUV (≥6 mm) might identify a subgroup of patients with small varices and thus a lesser likelihood of variceal bleeding.

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REFERENCES

  1. Burns P: Doppler flowmetry and portal hypertension. Gastroenterology 92:824-826, 1987

    Google Scholar 

  2. Subramanyam BR, Belthazar SJ, Madambra MR, Raghavendra BN, Horii SC, Lefleur RS: Sonography of portosystemic collaterals in portal hypertension. Radiology 146:161-166, 1983

    Google Scholar 

  3. Bolondi L, Bassi S, Giani S: Doppler flowmetry in portal hypertension. J Gastroenterol Hepatol 5:459-467, 1990

    Google Scholar 

  4. Saddekni S, Hutchinson DE, Cooperberg PL: The sonographically patent umbilical vein in portal hypertension. Radiology 145:441-443, 1982

    Google Scholar 

  5. Gibson RN, Gibson PR, Donlan JD, Clunie DA: Identification of a patent paraumbilical vein by using Doppler sonography: Importance in the diagnosis of portal hypertension. AJR 153:513-516, 1989

    Google Scholar 

  6. Mostbeck GH, Wittich GR, Herold C, Vergesslich KA, Walter RM, Frotz S, Somoner G: Hemodynamic significance of the paraumbilical vein in portal hypertension: Assessment with duplex US. Radiology 170:339-342, 1989

    Google Scholar 

  7. DiCandio G, Compatelli A, Mosca F, Santi V, Casanova P, Bolondi L: Ultrasound detection of unusual spontaneous portosystemic shunts associated with uncomplicated portal hypertension. J Ultrasound Med 4:297-305, 1985

    Google Scholar 

  8. Abraham AS, Atkinson M: The disappearance of ascites in alcoholic cirrhosis with the development of the Cruveilhier-Baumgarten syndrome. Ann Intern Med 62:1045-1049, 1965

    Google Scholar 

  9. Aagaard J, Jensen LI, Sorensen TIA, Christensen U, Burcharth F: Recanalized umbilical vein in portal hypertension. AJR 139:1107-1109, 1982

    Google Scholar 

  10. Morin C, Lafortune M, Pomier G: Patent paraumbilical vein: Anatomic and hemodynamic variants and their clinical importance. Radiology 185:253-256, 1992

    Google Scholar 

  11. Sacerdoti D, Bolognesi M, Bombonato G, Gatta A: Paraumbilical vein patency in cirrhosis: effects on hepatic hemodynamics evaluated by Doppler sonography. Hepatology 22:1689-1694, 1995

    Google Scholar 

  12. Foutch PG, Sullivar JA, Gaines JA, Sanowski RA: Cutaneous vascular spiders in cirrhotic patients:correlation with hemorrhage from esophageal varices. Am J Gastroenterol 83:723-726, 1988

    Google Scholar 

  13. Paquet KJ, Oberhammer E: Sclerotherapy of bleeding esophageal varices by means of endoscopy. Endoscopy 10:7-11, 1978

    Google Scholar 

  14. Salmi A, Paterlini A: Sonographic patent umbilical vein: Lack of specificity for portal hypertension. Am J Gastroenterol 81:556-558, 1986

    Google Scholar 

  15. Lafortune M, Constantin A, Breton G, Legare AG, Lavoie P: The recanalized umbilical vein in portal hypertension: A myth. AJR 144:549-553, 1985

    Google Scholar 

  16. Wachsberg RH, Obolevich AT: Blood flow characteristics of vessels in the ligamentum teres fissure at color doppler sonography: Findings in healthy volunteers and in patients with portal hypertension. AJR 164:1403-1405, 1995

    Google Scholar 

  17. Obel W: The umbilical vein in different periods of life in man. Folia Morphol 2:173-179, 1976

    Google Scholar 

  18. Vilgrain V, Lebrec D, Menu Y: Comparison between ultrasonographic signs and the degree of portal hypertension in patients with cirrhosis. Gastrointest Radiol 15:218-222, 1990

    Google Scholar 

  19. Glazer GM, Laing FC, Brown TW, Gooding GAW: Sonographic demonstration of portal hypertension: The patent umbilical vein. Radiology 136:161-163, 1980

    Google Scholar 

  20. Schabel SI, Rittenberg GM, Javid LH, Cunningham J, Ross P: The “bull's-eye” falciform ligament: A sonographic finding of portal hypertension. Radiology 136:157-159, 1980

    Google Scholar 

  21. Lam KC, Juttner HU, Reynolds TB: Spontaneous portosystemic shunt: relationship to spontaneous encephelopathy and gastrointestinal hemorrhage. Dig Dis Sci 26:254-258, 1981

    Google Scholar 

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  1. Departments of Hepatology and Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Dhiraj Gupta, Yogesh K. Chawla, Radha K. Dhiman, Sudha Suri & Jang B. Dilawari

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  1. Dhiraj Gupta
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  2. Yogesh K. Chawla
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  3. Radha K. Dhiman
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  4. Sudha Suri
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  5. Jang B. Dilawari
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Gupta, D., Chawla, Y.K., Dhiman, R.K. et al. Clinical Significance of Patent Paraumbilical Vein in Patients with Liver Cirrhosis. Dig Dis Sci 45, 1861–1864 (2000). https://doi.org/10.1023/A:1005505522151

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  • DOI: https://doi.org/10.1023/A:1005505522151

  • paraumbilical vein
  • cirrhosis
  • hepatic encephalopathy