Real-time ultrasound in determination of portasystemic shunt patency in children.

Portasystemic anastomoses continue to play an important role in the management of children with extrahepatic and intrahepatic portal venous obstruction. Postoperative documentation of shunt patency has depended upon demonstration of early caval filling with visceral angiography. This report details the use of real-time ultrasound in the demonstration of the patency of portasystemic anastomoses in seven children. The shunts, of various anatomic configuration, have been imaged and calibrated successfully in each case. Real-time ultrasound is an accurate and noninvasive method for evaluating portasystemic anastomoses and should replace visceral angiography in most children.