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• W2022764676 abstract "Background: PH is a severe complication of chronic liver disease. Its instrumental diagnostic parameters may suffer from specific pitfalls which include false negative, failures, invasivity and operator-dependance. Aims: To assess the role of PS in the staging of PH in children with chronic cholestasis. Patients and Methods: 18 children (10 males; mean age ± SD 7.9 ± 5.7; range 0.4-18 years) affected by surgically corrected Biliary Atresia (n=13), Alagille S.(n=2), Byler D. (n=1), Congenital Hepatic Fibrosis (n=1), Sclerosing cholangitis (n=1) underwent PS. In the case of PH, PS may reveal a pattern of rapid cardiac appearance of the radionuclide injected in the upper rectum (abnormal pattern). Quantitation of the percentage of blood which enters the portal system and goes to heart rather than to liver (portal shunt-index, SI) is possible as well (D'Arienzo et al. J Hepatol 1992; 14: 188). SI (reference limits for non cirrhotics <19%) and PS patterns were statistically correlated with clinical and laboratory data of portal hypertension and/or hypersplenism, endoscopic evidence of oesophageal varices (OV), ultrasonographically (US) determined lesser omentum/abdominal aorta diameter ratio (LO/Ao; reference limits for non cirrhotics < 1.7), flux (PF) and diameter (PD) of portal vein, liver (LLD) and spleen (SLD) longitudinal diameters/ sqm body area surface. SI and PS patterns were correlated also with clinical and laboratory variables of prognostic significance for pre-transplantation death-risk (cholesterol, aPTT, unconjugated bilirubin, ascites: score of Malatack et al. J Pediatr 1987; 11:479). Results: PS patterns were abnormal in 70% and 20% (p=0.08) of pts with extra-and intra-hepatic cholestasis, respectively; in these pts SI were 42 ± 21 and 24±11(p=0.09), respectively. Statistics with several items of PH is shown below. Table Conclusions: A collateral flow from the portal system to the systemic circulation through the rectal veins bed often develops in children with chronic cholestasis. PS allows to obtain an early diagnosis of PH expecially in young patients affected by Biliary Atresia and in those with o.varices and/or at high risk for pretransplant death. SI correlates with US liver and spleen sizes but not with US data of shunt in the upper GI tract. PS may be an advantageous tool complementary to US in the non-(or poorly-)invasive evaluation of PH in children" @default.
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• W2022764676 title "TECHNETIUM-99M PERTECHNETATE PER-RECTAL PORTAL SCINTIGRAPHY (PS) IN THE STAGING OF PORTAL HYPERTENSION (PH) IN CHILDREN WITH CHRONIC CHOLESTASIS" @default.
• W2022764676 doi "https://doi.org/10.1097/00005176-199704000-00172" @default.
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