Abstract: Objective There is a dense collagen deposition in hepatic sinusoide in patients with severe acute alcoholic hepatitis (SAAH), which increase the sinusoidal resistance with increased pressure and block blood flow through hepatic sinusoids. The portal vein blood flow is compromised in a retrograde manner with obviously reduced portal venous perfusion. Consequently, the hepatic artery buffering response (HABR) is triggered to counteract the decreased blood flow from hepatic artery or portal vein to maintain a physiological requirement and restore the hepatic perfusion, e.g., the sum of hepatic artery and portal vein blood flow. The hepatic hemodynamics and quantitative HABR can be assessed by Duplex Doppler ultrasonography, and the latter could be a noninvasive approach for the diagnosis of SAAH.

Key words: Severe acute alcoholic hepatitis, Hepatic artery buffering response, Duplex Doppler ultrasonography