Mandatory medical device diagnostics.
- Angiography (imaging of blood vessels by contrast medium in an X-ray examination) – to visualize collateral vessels.
- Determination of hepatic vein pressure gradient (LVDG = difference between free hepatic vein pressure (FLVD) and hepatic vein occlusion pressure (LVVD)) – indirect measurement of portal pressure (cathetization of a hepatic vein); hepatic vein occlusion pressure and portal pressure correlate well with each other; measurement is used in addition to the diagnosis of:
- Assessment of the development of complications
- Monitoring of pharmacotherapy/medicinal therapy.
- Estimation of progression (progression) of portal hypertension.
- Color duplex sonography – simplest method, but relatively inaccurate; pressure can be estimated based on sequelae.
- Dilatation (widening) of the portal vein.
- Decreased portal flow velocity
- Abolished respiratory variability of the splenic and splanchnic (visceral) veins.
- Reversal of blood flow
- Detection of porto-caval collaterals (bypass circuits).
- Esophagogastroduodenoscopy (OGD) – endoscopy of the esophagus (esophagus), gastros (stomach), and upper part of the duodenum (duodenum) to detect esophageal and fundal varices as caused by portal hypertension.
- Abdominal ultrasonography (ultrasound examination of the abdominal organs) – to detect splenomegaly (splenomegaly) and/or ascites (abdominal dropsy), as well as anastomoses (bypass circulations)
Directly, the increased portal pressure can only be determined invasively, that is, intraoperatively. However, this is not performed in practice due to a high technical effort as well as associated risks.
