GALLBLADDER VARICES IN PORTAL-VEIN THROMBOSIS

OBJECTIVE. We performed a prospective study to determine the frequency that gallbladder varices are seen on duplex sonograms of patients with portal vein thrombosis. SUBJECTS AND METHODS. Findings of gallbladder wall varices were sought on duplex Doppler sonograms of 74 patients with portal vein thrombosis. The diagnosis of portal vein obstruction was made on the basis of sonographic or splenoportographic findings. RESULTS. Sonography showed gallbladder varices in 22 (30%) of 74 patients. Varices were defined as anechoic, serpentine areas in the wall of the gallbladder showing venous flow on Doppler imaging. However, no gallbladder varices were detected in six patients who had patent surgical splenorenal shunts. Gallbladder varices did not correlate with the site and extent of portal vein thrombosis, the presence of a spontaneous (natural) splenorenal shunt, or endoscopic obliteration of varices. CONCLUSION. Gallbladder varices are common in patients with portal thrombosis. Awareness of gallbladder varices should increase the surgeon's caution during biliary tract surgery in patients with portal hypertension.