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Endoscopy 2008; 40(8): 690-696
DOI: 10.1055/s-2008-1077400
Review

© Georg Thieme Verlag KG Stuttgart · New York

EUS for portal hypertension: a comprehensive and critical appraisal of clinical and experimental indications

M.  El-Saadany1 , S.  Jalil2 , A.  Irisawa3 , G.  Shibukawa3 , H.  Ohira3 , M.  S.  Bhutani4
  • 1Internal Medicine Department, Faculty of Medicine, Mansoura University, Egypt
  • 2Division of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston, Texas, USA
  • 3Department of Internal Medicine 2, Fukushima Medical University School of Medicine, Fukushima, Japan
  • 4Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Further Information

Publication History

submitted 31 December 2007

accepted after revision 14 April 14 2008

Publication Date:
07 July 2008 (online)

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Endoscopic ultrasonography (EUS) has significantly improved our understanding of the complex vascular structural changes that occur in portal hypertension and their clinical and prognostic significance. EUS in combination with color Doppler technique enables us to study the hemodynamic changes in the portal venous system noninvasively, and to determine objectively the effect of different pharmacological agents on portal hypertension. EUS has also found some role in the treatment and follow up of esophageal and gastric varices. It may play a clinical role in the diagnosis of gastric, duodenal, and rectal varices. Recently reported EUS-based devices that measure variceal wall tension and intravariceal pressure noninvasively could have an impact on the identification of patients at high risk of variceal bleeding with the aim of initiating prophylactic treatment, and in the assessment of patients’ responses to drug therapy of portal hypertension. EUS is occasionally very helpful in the clinical management of portal hypertension. It is an interesting and important research tool for many experimental indications that are not routinely applied in clinical practice at this time.

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M. S. Bhutani, MD, FACG

Department of Gastroenterology, Hepatology and Nutrition, Unit 436
University of Texas
MD Anderson Cancer Center

Faculty Center
Room 10.2028
1515 Holcombe Blvd
Houston
TX 77030-4009
USA

Fax: +1-713-5634398

Email: Manoop.Bhutani@mdanderson.org