Ultrasound in Portal Hypertension - Part 2-and EFSUMB Recommendations for the Performance and Reporting of Ultrasound Examinations in Portal Hypertension

Patients with clinical/laboratory findings of PH in the absence of known chronic liver disease (CLD), and patients with sonographic signs of possible portal hypertension Morphological signs of cirrhosis should initially also be looked for in this setting. However, the chance of encountering non-cirrhotic causes of PH is increased in these patients, and special attention should be paid to the assessment of vascular patency, since portal vein thrombosis and hepatic veins thrombosis are the most frequent causes of non-cirrhotic portal hypertension. Color (and power) Doppler US (CDUS) is > 90 % accurate for diagnosing portal vein thrombosis/portal cavernomas and hepatic vein disturbances (Budd-Chiari Syndrome) ((sic) Fig. 1). Cardiac causes and arterioportal fistulae can be also identified. Rarer causes of PH (including idiopathic PH or nodular regenerative hyperplasia) should be suspected in patients with signs of PH and no other apparent cause, and should be investigated with appropriate invasive means.