Shahbaz Haider1, Qurban Hussain2, Sumera Tabassum3, Bilal Hussain4, Muhammad Rasheed Durrani5, Fayyaz Ahmed6. 1. Dr. Shahbaz Haider, FCPS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan. 2. Dr. Qurban Hussain, FCPS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan. 3. Dr. Sumera Tabassum, FCPS. Department of Radiology, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan. 4. Dr. Bilal Hussain, MBBS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan. 5. Dr. Muhammad Rasheed Durrani, FCPS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan. 6. Dr. Fayyaz Ahmed, MBBS. Department of Radiology, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
Abstract
OBJECTIVE: To estimate the effect of portal pressure lowering drug 'octreotide', by observing the Doppler waveform before and after the administration of intravenous bolus of octreotide and thus to assess indirectly its efficacy to lower the portal pressure. METHODS: This quassi experimental study was carried out in Medical Department in collaboration with Radiology Department of Jinnah Postgraduate Medical Center Karachi Pakistan from September 10, 2015 to February 5, 2016. Cases were selected from patients admitted in Medical Wards and those attending Medical OPD. Diagnosis of cirrhosis was confirmed by Clinical Examination and Lab & Imaging investigation in Medical Department. Doppler waveform study was done by experienced radiologist in Radiology Department before and after administration of octreotide. Doppler signals were obtained from the right hepatic vein. Waveform tracings were recorded for five seconds and categorized as 'monophasic', 'biphasic' and 'triphasic'. Waveform changes from one waveform to other were noted and analyzed. RESULTS: Significant change i.e. from 'monophasic' to 'biphasic' or 'biphasic' to 'triphasic' was seen in 56% cases while 'monophasic' to 'triphasic' was seen in 20% cases. No change was seen in 24% cases. Improvement in waveform reflects lowering of portal vein pressure. CONCLUSION: Non invasive Hepatic vein Doppler waveform study showed improvement in Doppler waveform after administration of octreotide in 76% cases. Doppler waveform study has the potential of becoming non invasive 'follow up tool' of choice for assessing portal pressure in patients having variceal bleed due to portal hypertension.
OBJECTIVE: To estimate the effect of portal pressure lowering drug 'octreotide', by observing the Doppler waveform before and after the administration of intravenous bolus of octreotide and thus to assess indirectly its efficacy to lower the portal pressure. METHODS: This quassi experimental study was carried out in Medical Department in collaboration with Radiology Department of Jinnah Postgraduate Medical Center Karachi Pakistan from September 10, 2015 to February 5, 2016. Cases were selected from patients admitted in Medical Wards and those attending Medical OPD. Diagnosis of cirrhosis was confirmed by Clinical Examination and Lab & Imaging investigation in Medical Department. Doppler waveform study was done by experienced radiologist in Radiology Department before and after administration of octreotide. Doppler signals were obtained from the right hepatic vein. Waveform tracings were recorded for five seconds and categorized as 'monophasic', 'biphasic' and 'triphasic'. Waveform changes from one waveform to other were noted and analyzed. RESULTS: Significant change i.e. from 'monophasic' to 'biphasic' or 'biphasic' to 'triphasic' was seen in 56% cases while 'monophasic' to 'triphasic' was seen in 20% cases. No change was seen in 24% cases. Improvement in waveform reflects lowering of portal vein pressure. CONCLUSION: Non invasive Hepatic vein Doppler waveform study showed improvement in Doppler waveform after administration of octreotide in 76% cases. Doppler waveform study has the potential of becoming non invasive 'follow up tool' of choice for assessing portal pressure in patients having variceal bleed due to portal hypertension.
Authors: A Escorsell ; J C Bandi; V Andreu; E Moitinho; J C García-Pagán; J Bosch; J Rodés Journal: Gastroenterology Date: 2001-01 Impact factor: 22.682
Authors: Moon Young Kim; Soon Koo Baik; Dong Hun Park; Dae Wook Lim; Jae Woo Kim; Hyun Soo Kim; Sang Ok Kwon; Young Ju Kim; Sei Jin Chang; Samuel S Lee Journal: Liver Int Date: 2007-10 Impact factor: 5.828