Liver stiffness is able to differentiate hepatosplenic Schistosomiasis mansoni from liver cirrhosis and spleen stiffness may be a predictor of variceal bleeding in hepatosplenic schistosomiasis

2021 ◽  
Author(s):  
Catherine F Silva ◽  
Mateus J Nardelli ◽  
Fernanda A Barbosa ◽  
Humberto O Galizzi ◽  
Tereza C M F Cal ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
Transient Elastography ◽  
Characteristic Curve ◽  
Liver Stiffness ◽  
Vein Thrombosis ◽  
Spleen Stiffness ◽  
Hepatosplenic Schistosomiasis

Abstract Background Ultrasonography is limited for differentiating portal hypertension due to liver cirrhosis from that secondary to hepatosplenic schistosomiasis (HSS). We aimed to investigate the role of transient elastography (TE) in differentiating HSS mansoni from cirrhosis and the factors associated with liver and spleen stiffness (LS and SS) in HSS. Method A cross-sectional study was conducted including patients with HSS mansoni (n=29) and liver cirrhosis due to non-alcoholic steatohepatitis (n=23). All patients underwent TE and those with HSS were assessed by the Niamey protocol. Results HSS subjects presented lower median LS (9.6 vs 21.3 Kpa, p<0.001) and liver controlled attenuation parameter (229 vs 274 dB/m, p=0.010) than cirrhosis subjects, in addition to higher SS (73.5 vs 42.2 Kpa, p=0.002). The area under the receiver operating characteristic curve for detecting cirrhosis by LS was 0.947 (95% CI 0.89 to 1.00, p<0.001), with an optimal cut-off of 11.75 Kpa. In HSS subjects, higher SS was associated with the presence of the following: diabetes mellitus (p=0.036), metabolic syndrome (p=0.043), esophageal varices (p=0.001), portal vein thrombosis (p=0.047) and previous variceal bleeding (p=0.011). In HSS patients without portal vein thrombosis, variceal bleeding was associated with higher SS (p=0.018). Niamey categories were not associated with LS (p=0.676) or SS (p=0.504). Conclusion TE can play a role in differentiating HSS from cirrhosis, especially by LS. SS may be further investigated for predicting complications in HSS.

Emergent treatment of variceal bleeding in two infants

2008 ◽  
Vol 49 (8) ◽  
pp. 951-954 ◽  
Author(s):  
A. Park ◽  
W. Cwikiel
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Biliary Atresia ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
The Other ◽  
Bleeding Control ◽  
Vein Thrombosis ◽  
Life Threatening

Two infants with portal hypertension were treated on an emergency basis for life-threatening uncontrollable variceal bleeding. One 9-month-old girl had portal vein thrombosis, and the other 28-months-old girl had liver cirrhosis secondary to biliary atresia. Following percutaneous transhepatic embolization of the varices, successful bleeding control was achieved in both patients.

scholarly journals Impact of Portal Vein Thrombosis on Endoscopic Variceal Band Ligation in Liver Cirrhosis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yue Huang
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
Band Ligation ◽  
Vein Thrombosis ◽  
End Point ◽  
Retrosternal Pain ◽  
The Impact

Background. Portal vein (PV) thrombosis (PVT) is a common complication of liver cirrhosis and can refer to thrombosis within the PV that can extend to its left or right branches and in some cases to the superior mesenteric vein or the splenic vein (Chawla and Bodh, 2015). For severe PVT patients, there are possibilities of increasing PV resistance and reduction of the blood flow though PV towards liver, which exacerbate liver function damage meanwhile elevating the gastrointestinal variceal bleeding risk. Endoscopic Variceal band ligation (EVL) is often used to prevent esophageal variceal bleeding; postoperative complications such as severe gastrointestinal bleeding and bleeding-related death, fever, retrosternal pain, and esophageal stenosis may appear. There was absence of the research which evaluated the impact of PVT in liver cirrhosis on the complication of endoscopic Variceal band ligation for now. We herein aimed to compare cirrhosis patients with and without PVT of recent complications after EVL. Method. We established the retrospective investigation on 144 consecutive cirrhosis patients (excluding patients with hepatocellular carcinoma and who received portal vein-systemic circulation devascularization or shunt surgery, splenectomy, hepatectomy, liver transplantation, transjugular intrahepatic portal vein stent shunt (TIPS), endoscopic varices Variceal ligation, or sclerotherapy before) who have received first endoscopic esophageal varices band ligation in Gastrointestinal Endoscopy Center of the First Affiliated Hospital, College of Medicine, ZheJiang University, between January 2014 and December 2017. Portal vein Doppler ultrasonography, liver computerized tomography (CT), and angiography or liver-enhanced magnetic resonance imaging (MRI) were applied to evaluate the portal vein thrombosis of each patient before EVL. There were 18 patients confirmed with portal vein thrombosis while the other 126 patients without PVT. The primary end point for this research is the upper gastrointestinal hemorrhage and related death occurred from the date of ligation until leaving hospital, and the secondary end point is the appearance of postoperative fever and retrosternal pain. Results. There are no significant differences of gastrointestinal bleeding, bleeding-related death, fever, or retrosternal pain after EVL and the length of hospital stays between cirrhotic patients with or without PVT ( P = 0.34 , 0.51 , 0.58 , 0.61 , 0.88 ). Conclusion. Liver cirrhosis with portal vein thrombosis did not increase incidence of recent complications of the endoscopic Variceal band ligation.

Antiphospholipid Antibodies and Antiphospholipid Syndrome: Role in Portal Vein Thrombosis in Patients With and Without Liver Cirrhosis

2010 ◽  
Vol 17 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Lucio Amitrano ◽  
Paul R. J. Ames ◽  
Maria Anna Guardascione ◽  
Luis R. Lopez ◽  
Antonella Menchise ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Vein Thrombosis

scholarly journals “SPLEEN STIFFNESS MEASUREMENT IN LIVER CIRRHOSIS PATIENTS FOR NONINVASIVE ASSESSMENT OF ESOPHAGEAL VARICES USING FIBROSCAN”

2020 ◽  
pp. 1-2
Author(s):  
Revathy Marimuthu Shanmugam ◽  
Vinay C ◽  
Sathya Gopalasamy ◽  
Chitra Shanmugam
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Esophageal Varix ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Surrogate Marker ◽  
Stiffness Measurement ◽  
Spleen Stiffness ◽  
Cirrhotic Patients

BACKGROUND: Many noninvasive surrogate marker for Portal hypertension or for the presence or grade of esophageal varices were studied..Splenomegaly along with splenic congestion secondary to splenic hyperdynamic circulation is seen secondary to Portal hypertension in cirrhotic patients that can be quantified by elastography. AIM:The aim of this study was to investigate whether spleen stiffness, assessed by TE, useful tool for grading chronic liver diseases and to compare its performance in predicting the presence and size of esophageal varices in liver cirrhosis patients. METHODOLOGY:86 patients with cirrhosis and 80 controls underwent transient elastography of liver and spleen for the assessment of liver stiffness (LSM) and spleen stiffness (SSM) . Upper GI endoscopy done in all Cirrhotic patients. RESULTS: Spleen stiffness showed higher values in liver cirrhosis patients as compared with controls: 58.2 kpa vs14.8 kpa (P < 0.0001) and also found to be significantly higher in cirrhotic patients compared with varices and those without varices (69.01 vs 42.05 kpa, P < 0.0001). Liver stiffness was also found to be higher in cirrhotic patients with varices when compared to patients without varices (38.5vs 21.2 kpa). Using both liver and spleen stiffness measurement we can predicted the presence of esophageal varices correctly. CONCLUSION: Spleen stiffness can be assessed using transient elastography, higher value correlated well with liver cirrhosis and presence of esophageal varices although it couldn’t correlate with grade of Esophageal Varix. Combined assessment of spleen and liver stiffness had better prediction of presence of Esophageal Varix.

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