Duplex Ultrasonography of the Mesenteric Circulation

  • William R. Flinn
  • Gail P. Sandager


Arterial occlusive disease of the celiac and superior mesenteric arteries is rare and patients with symptomatic mesenteric ischemia are encountered infrequently. However, the clinical manifestations of mesenteric occlusive lesions remain enigmatic and range from asymptomatic to catastrophic. Acute occlusions of the celiac artery (CA) and the superior mesenteric artery (SMA) due to thrombosis or embolism can produce extensive, irreversible gut ischemia requiring emergency treatment, and the mortality from these events remains among the highest of all vascular emergencies. The true incidence of chronic atherosclerotic occlusive disease of the main mesenteric vessels is not well established, the precise relationship to symptoms is poorly understood, and the rate of disease progression is undocumented.


Superior Mesenteric Artery Duplex Ultrasonography Celiac Trunk Celiac Artery Duplex Scanning 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Flinn WR, Sandager GP, Lilly MP, et al. Duplex scan of mesenteric and celiac arteries. In: Bergan JJ, Yao JST (eds) Arterial surgery: new diagnostic and operative techniques. Orlando, FL: Grune and Stratton 1988:367.Google Scholar
  2. 2.
    Blackburn DR. Color duplex imaging of the mesenteric and renal arteries. J Vasc Technol 1991;15:139.Google Scholar
  3. 3.
    Sandager GP, Zimmer S, Silva MB, Flinn WR. Ultrasonographic characteristics of transvenous vena caval interruption devices. J Vasc Technol 1992;16:17–21.Google Scholar
  4. 4.
    Ackroyd N, Gill R, Griffiths K, et al. Duplex scanning of the portal vein and portasystemic shunts. Surgery 1986;90:591Google Scholar
  5. 5.
    Ralls PW. Color doppler sonography of the hepatic artery and portal venous system. AJR 1990;155:517.PubMedCrossRefGoogle Scholar
  6. 6.
    Grant EG, Tessler FN, Gomes AS, et al. Color doppler imaging of portosystemic shunts. AJR 1990;154:393.PubMedCrossRefGoogle Scholar
  7. 7.
    Rizzo RJ, Sandager G, Astleford P, et al. Mesenteric flow velocity variations as a function of angle of insonation. J Vasc Surg 1990;11:688.PubMedGoogle Scholar
  8. 8.
    Healy DA, Neumeyer MM, Atnip RG, Thiele BL. Evaluation of mesenteric vascular disease with duplex ultrasound. Circulation 1990;82(SupplIII):460.Google Scholar
  9. 9.
    Moneta GL, Yeager RA, Dalman R, et al. Duplex ultrasound criteria for diagnosis of splanchnic artery stenosis or occlusion. J Vasc Surg 1991;14:511–520.PubMedCrossRefGoogle Scholar
  10. 10.
    Moriyasu F, Ban N, Nishida O, et al. Clinical application of an ultrasonic duplex system in the quantitative measurement of portal blood flow. J Clin Ultrasound 1986;14:579.PubMedCrossRefGoogle Scholar
  11. 11.
    Sato S, Ohnishi K, Sugita S, Okuda K. Splenic artery and superior mesenteric artery blood flow: nonsurgical Doppler US measurement in healthy subjects and patients with chronic liver disease. Radiology 1987;164:347.PubMedGoogle Scholar
  12. 12.
    Qamar MI, Read AE, Skidmore R, et al. Transcutaneous doppler ultrasound measurement of coeliac axis blood flow in man. Br J Surg 1985;72:391.PubMedCrossRefGoogle Scholar
  13. 13.
    Qamar MI, Read AE, Mountford R. Increased superior mesenteric artery blood flow after glucose but not lactulose ingestion. Q J Med 1986;233:893.Google Scholar
  14. 14.
    Jäger K, Bollinger A, Vallie C, Ammann R. Measurement of mesenteric blood flow by duplex scanning. J Vasc Surg 1986;3:462.PubMedCrossRefGoogle Scholar
  15. 15.
    Moneta GL, Taylor DC, Helton WS, et al. Duplex ultrasound measurement of postprandial intestinal blood flow: effect of meal composition. Gastroenterology 1988;95:1294.PubMedGoogle Scholar
  16. 16.
    Gill RW. Measurement of blood flow by ultrasound: accuracy and sources of error. Ultrasound Med Biol 1985; 11:625.PubMedCrossRefGoogle Scholar
  17. 17.
    Hoskins PR. Measurement of arterial blood flow by Doppler ultrasound. Clin Phys Physiol Meas 1990;11:1.PubMedCrossRefGoogle Scholar
  18. 18..
    Taylor GA. Blood flow in the superior mesenteric artery: estimation with doppler US. Radiology 1990; 174:15.PubMedGoogle Scholar
  19. 19.
    Lilly MP, Harward TRS, Flinn WR, et al. Duplex ultrasound measurement of changes in mesenteric flow velocity with pharmacologic and physiologic alteration of intestinal blood flow in man. J Vasc Surg 1989;9:18.PubMedGoogle Scholar
  20. 20.
    Flinn WR, Rizzo RJ, Park JS, Sandager GP. Duplex scanning for assessment of mesenteric ischemia. Surg Clin North Am 1990;70:99.PubMedGoogle Scholar
  21. 21.
    Nishida O, Moriyasu F, Nakamura T, et al. Relationship between splenic and superior mesenteric venous circulation. Gastroenterology 1990;98:721.PubMedGoogle Scholar
  22. 22.
    Gooding GAW. Ultrasound of a superior mesenteric artery aneurysm secondary to pancreatitis: a plea for real-time ultrasound of sonolucent masses in pancreatitis. J Clin Ultrasound 1981;9:255.PubMedCrossRefGoogle Scholar
  23. 23.
    Bret PM, Bretagnolle M, Enoch G, et al. Ultrasonic features of aneurysms of splanchnic arteries. J Can Assoc Radiol 1985;36:226.PubMedGoogle Scholar
  24. 24.
    Mourad K, Guggiana P, Minasian H. Superior mesenteric artery aneurysm diagnosed by ultrasound. Br J Radiol 1987;60:287.PubMedCrossRefGoogle Scholar
  25. 25.
    Paolella L, Scola FH, Cronan JJ: Hepatic artery aneurysm: an ultrasound diagnosis. J Clin Ultrasound 1985;13:360.PubMedCrossRefGoogle Scholar
  26. 26.
    Stokland E, Wihed A, Ceder S, et al. Ultrasonic diagnosis of an aneurysm of the common hepatic artery. J Clin Ultrasound 1985;13:369.PubMedCrossRefGoogle Scholar
  27. 27.
    Bolondi L, Casanova P, Arienti V, et al. A case of aneurysm of the splenic artery visualized by dynamic ultrasonography. Br J Radiol 1981;54:1109.PubMedCrossRefGoogle Scholar
  28. 28.
    Derchi LE, Biggi E, Cicio GR. Aneurysms of the splenic artery: noninvasive diagnosis by pulsed Doppler sonography. J Ultrasound Med 1984;3:41.PubMedGoogle Scholar
  29. 29.
    Green D, Carroll BA. Aneurysm of the gastroduodenal artery causing biliary obstruction: real-time ultrasound diagnosis. J Ultrasound Med 1984;3:375.PubMedGoogle Scholar
  30. 30.
    Verma BS, Bose AK, Bhatia HC, Katoch R. Superior mesenteric artery branch aneurysm diagnosed by ultrasound. Br J Radiol 1991;64:169.PubMedCrossRefGoogle Scholar
  31. 31.
    Grech P, Rowlands P, Crofton M. Aneurysm of the inferior pancreaticoduodenal artery diagnosed by real-time ultraound and pulsed Doppler. Br J Radiol 1989;62:753.PubMedCrossRefGoogle Scholar
  32. 32.
    Jäger KA, Fortner GS, Thiele BL, Strandness DE. Noninvasive diagnosis of intestinal angina. J Clin Ultrasound 1984;12.Google Scholar
  33. 33.
    Nicholls SC, Kohler TR, Martin RL, Strandness ED Jr. Use of hemodynamic parameters in the diagnosis of mesenteric insufficiency. J Vasc Surg 1986;3:507.PubMedGoogle Scholar
  34. 34.
    Hartnell GG, Gibson RN. Doppler ultrasound in the diagnosis of intestinal ischemia. Gastrointest Radiol 1987; 12:285.PubMedCrossRefGoogle Scholar
  35. 35.
    Moneta GL, Cummings C, Caston J, Porter JM. Duplex ultrasound demonstration of postprandial mesenteric hyperemia in splanchnic circulation collateral vessels. J Vasc Technol 1991;15:37.Google Scholar
  36. 36.
    Moneta GL, Lee RW, Yeager RA, et al. Mesenteric duplex scanning: a blinded prospective study. J Vasc Surg; 1993; 17:79–86.PubMedCrossRefGoogle Scholar
  37. 37.
    Bowersox JC, Zwolak RM, Walsh DB et al. Duplex ultrasonography in the diagnosis of celiac and mesenteric artery occlusive disease. J Vasc Surg 1991;14:780–788.PubMedCrossRefGoogle Scholar
  38. 38.
    Healy DA, Neumyer MM, Atnip RG, Thiele BL. Evaluation of celiac and mesenteric vascular disease with duplex ultrasonography. J Ultrasound Med 1992;11:481–485.PubMedGoogle Scholar
  39. 39.
    Sandager G, Flinn WR, McCarthy WJ, et al. Assessment of visceral arterial reconstruction using duplex scan. J Vasc Technol 1987;11:13.Google Scholar
  40. 40.
    McMillan WD, McCarthy WJ, Bresticker MR, et al. Mesenteric artery bypass: objective patency determination. J Vasc Surg 1995;21:729–741.PubMedCrossRefGoogle Scholar
  41. 41.
    Takahashi H, Takezawa, Okada T, et al. portal blood flow measured by duplex scanning during mesenteric infarction. Crit Care Med 1986;14:253.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2000

Authors and Affiliations

  • William R. Flinn
  • Gail P. Sandager

There are no affiliations available

Personalised recommendations