scholarly journals DOI: 10.14260/jemds/201 5 / 1 0 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN - 2278 - 4802 , pISSN - 2278 - 4748/ Vol . 4 / Issue 01 / Jan 01 , 201 5 Page 59 A STUDY OF CORRELATION OF ESOPHAGEAL VARICES IN CIRRHOTIC PATIENTS WITH PORTAL HAEMODYNAMICS WITH SPECIAL REFERENCE TO PORTAL VEIN DIAMETER, PORTAL VEIN VELOCITY, CONGESTION INDEX, LIVER VASCULAR INDEX

2014 ◽  
Vol 4 (01) ◽  
pp. 59-66
Author(s):  
Arvind Chouhan ◽  
Sushma Trikha ◽  
Sanjay Dhawle ◽  
Jyoti Nagwanshi ◽  
Subhash Chandra
Keyword(s):  
Portal Vein ◽  
Special Reference ◽  
Esophageal Varices ◽  
Vein Diameter ◽  
Cirrhotic Patients ◽  
Congestion Index

scholarly journals Study of Portal Vein Diameter and Spleen Size by Ultrasonography and Their Association with Gastro-esophageal Varices

2017 ◽  
Vol 4 (2) ◽  
pp. 6-14
Author(s):  
Subash Bhattarai ◽  
M Gyawali ◽  
KR Dewan ◽  
G Shrestha ◽  
BS Patowary ◽  
...  
Keyword(s):  
Portal Vein ◽  
Esophageal Varices ◽  
Spleen Size ◽  
Cutoff Value ◽  
Non Invasive ◽  
Vein Diameter ◽  
Cirrhotic Patients ◽  
Positive Correlations ◽  
Cirrhosis Of Liver

 Introduction: Upper Gastro-intestinal endoscopy is considered the best screening tool for varices in cirrhotic patients. It is still an expensive, invasive tool, has poor compliance and not routinely available in every hospitals in Nepal. This study was undertaken to establish the role of portal vein diameter and spleen size by ultrasonography in predicting gastro-esophageal varices.Method: One hundred and fifty patients with clinical features, laboratory and sonological findings suggestive of cirrhosis of liver and endoscopic evidence of portal hypertension were included in the study. Ultrasonography assessments of portal vein diameter and spleen size alongside endoscopy for detection of varices were done.Result: Average portal vein diameter of patients without gastro-esophageal varices was 10.800 ± 1.1402 mm, while it was 13.731 ± 1.061mm in patients with varices(p<0.001). Average spleen size of patients without varices was 12.67 ± 2.35 cm and with varices was 15.367 ± 1.210 cm (p < 0.001). There was 92.72 % sensitivity and 90 % specificity for prediction for presence of esophageal varices when the cutoff value for portal vein diameter was 12.25 mm. There was 94.5 % sensitivity and 75 % specificity for prediction for presence of esophageal varices when the cutoff value for spleen size was 13.9 cm.Conclusion: Ultrasonography of portal vein diameter and spleen size is a reliable non invasive tool in predicting the presence of gastro-esophageal varices in patients with liver cirrhosis. With increase in portal vein diameter and spleen size, risk of formation of gastro-esophageal varices also increases and positive correlations exist between them. Nepalese Journal of Radiology, VOL 4 No. 2 ISSUE 7 July-December, 2014: 6-14 

scholarly journals A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Hany El-Assaly ◽  
Lamiaa I. A. Metwally ◽  
Heba Azzam ◽  
Mohamed Ibrahim Seif-Elnasr
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Imaging Modality ◽  
Splenic Vein ◽  
Gastric Varices ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
Vein Diameter

Abstract Background Portal hypertension is a major complication resulting from obstruction of portal blood flow, like cirrhosis or portal vein thrombosis, that leads to portal hypertension. MDCT angiography has become an important tool for investigation of the liver as well as potentially challenging varices by detailing the course of these tortuous vessels. This information is decisive for liver transplantation as well as for common procedures in which an unexpected varix can cause significant bleeding. Results This study included an assessment of 60 cases of portal hypertension (28 males and 32 females), their age ranged from 42 to 69 years (mean age = 57.2 ± 6.63). All patients were diagnosed with portal hypertension, underwent upper GI endoscopy followed by a triphasic CT scan with CT angiographic assessment for the screening of gastro-esophageal varices. CT is highly sensitive as compared to upper GI endoscopy (sensitivity 93%) in detecting esophageal varices. Gastric varices detected by CT in 22 patients (37%) compared to 14 patients (23%) detected by endoscopy. While paraesophageal varices were detected in 63% of patients and retro-gastric varices in 80% of patients that were not visualized by endoscopy. Our study reported that the commonest type of collaterals were the splenic collaterals, and we also found there is a significant correlation between the portal vein diameter and the number of collaterals as well as between the portal vein diameter and splenic vein diameter. Conclusions Multi-slice CT serves as an important non-invasive imaging modality in the diagnosis of collaterals in cases of portal hypertension. CT portography can replace endoscopy in the detection of high-risk varices. It also proved that there is a correlation between portal vein diameter, splenic vein diameter, and number of collaterals.

scholarly journals Portal Vein Dopplerflowmetry in healthy sheep according to age

2017 ◽  
Vol 37 (10) ◽  
pp. 1172-1176 ◽  
Author(s):  
Alexandra F. Belotta ◽  
Bianca P. Santarosa ◽  
Danilo O.L. Ferreira ◽  
Sílvia M.F. Carvalho ◽  
Roberto C. Gonçalves ◽  
...  
Keyword(s):  
Blood Flow ◽  
Portal Vein ◽  
Portal Blood Flow ◽  
Portal Blood ◽  
Mean Values ◽  
Pulsed Doppler Ultrasound ◽  
Healthy Sheep ◽  
Vein Diameter ◽  
Congestion Index ◽  
Post Hoc

ABSTRACT: Pulsed Doppler ultrasound was used to evaluate portal blood flow, portal velocity and portal congestion index in 24 healthy sheep divided into groups (lambs, yearlings and ewes), according to age. Measurements were performed at the 11th right intercostal space using ideal insonation angle and uniform insonation method. Mean values obtained in each group were compared with one-way ANOVA, followed by Tukey post-hoc test. Portal velocity and portal blood flow were statistically similar between the groups (P>0.05). Mean portal velocity were 17.75; 17.13 and 16.75; while mean portal blood flow were 26.65; 31.04 and 24.32 for lambs, yearlings and ewes, respectively. Portal congestion index was statistically distinct between the groups and values for lambs, yearlings and ewes were 0.009; 0.058 and 0.09, respectively (P<0.01). Statistical differences were observed in portal vein diameter, portal vein area and portal congestion index between the groups, presumably due to influence of weight and not to age.

scholarly journals EFFECT OF NON-SELECTIVE BETA BLOCKERS ON ESOPHAGEAL VARICES AND PORTAL VEIN DIAMETER IN CIRRHOTIC HCV PATIENTS

2018 ◽  
Vol 24 (5) ◽  
pp. 449-456
Author(s):  
Ahmed Amin ◽  
Sahar Zaghloul ◽  
Khaled Lakouz ◽  
Essam Abdel Wahab ◽  
Waseem Seleem
Keyword(s):  
Portal Vein ◽  
Esophageal Varices ◽  
Beta Blockers ◽  
Vein Diameter

scholarly journals Role of portal color Doppler ultrasonography as noninvasive predictive tool for esophageal varices in cirrhotic patients

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Mohamed Alaa ELdin Nouh ◽  
Mohamed Kamel Abd-Elmageed ◽  
Amany Abas Mohamed Amer ◽  
Moamena Said ELhamouly
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Esophageal Varices ◽  
Resistance Index ◽  
Cirrhotic Liver ◽  
Control Group ◽  
Predictive Tool ◽  
Endoscopic Screening ◽  
Cirrhotic Patients

Abstract Background Esophageal varices (EV) is the most common apprehensive complication of portal hypertension in patients with cirrhotic liver. Guidelines recommend Upper gastro-intestinal endoscopic screening for EV in patients with newly diagnosed chronic cirrhosis (Imperiale et al. in Hepatology 45(4):870–878, 2007). Yet, it is invasive, time consuming and costly. To avoid unnecessary endoscopy, some studies have suggested Doppler ultrasound examination as simple, and noninvasive tool in prediction and assessment of severity of EV (Agha et al. in Dig Dis Sci 54(3):654–660, 2009). Our study was to assess the role of different Doppler indices of portal vein, hepatic and splenic arteries as a noninvasive tool for prediction of esophageal varices in cirrhotic patients. Results This prospective case control study was conducted on 100 cirrhotic liver patients and 100 of healthy volunteers as control group. Patients were subjected to clinical examination, upper gastrointestinal tract endoscopy, abdominal ultrasonography with duplex Doppler evaluation of different portal Doppler hemodynamic indices were done for each patient. The results revealed that portal vein diameter, hepatic artery pulsatility index, portal hypertensive index, portal vein flow velocity, portal congestion index have high sensitivity for prediction of EV. However, Splenic artery resistance index, hepatic artery resistance index HARI, liver vascular index and platelet count/spleen diameter have less sensitivity for prediction of EV. Conclusion Measuring the portal hemodynamic indices can help physicians as noninvasive predictors of EV in cirrhotic patients to restrict the need for unnecessary endoscopic screening especially when endoscopic facilities are limited.

scholarly journals Portal vein flow velocity as a possible fast noninvasive screening tool for esophageal varices in cirrhotic patients

JGH Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 589-594
Author(s):  
Yara N Elkenawy ◽  
Reda A Elarabawy ◽  
Layla M Ahmed ◽  
Abdallah A Elsawy
Keyword(s):  
Portal Vein ◽  
Flow Velocity ◽  
Esophageal Varices ◽  
Screening Tool ◽  
Portal Vein Flow ◽  
Cirrhotic Patients

scholarly journals Correlation of portal vein diameter with the presence of oesophageal varices in chronic liver disease: a prospective study

2018 ◽  
Vol 5 (4) ◽  
pp. 859 ◽  
Author(s):  
Suraj Uppalapati ◽  
Lokesh S.
Keyword(s):  
Portal Vein ◽  
Esophageal Varices ◽  
Previous History ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal Endoscopy ◽  
Non Invasive ◽  
Upper Gi ◽  
Vein Diameter ◽  
Cirrhosis Of Liver ◽  
A Prospective Study

Background: Guidelines recommends upper gastrointestinal endoscopy for all the patients with cirrhosis of liver to rule out portal hypertension. Many patients may not be willing to undergo this unpleasant procedure or resources may not be available. In this study, authors aim to identify the effectiveness of portal vein size as a non-invasive predictor of esophageal varices.Methods: In this prospective observational study of 30 patients, patients with liver cirrhosis without a previous history of upper GI bleeding were included between November 2012 and October 2014. Relevant clinical parameters were assessed which included physical examination, complete hemogram, biochemical workup, upper GI endoscopy and ultrasonographic measurement of portal vein diameter.Results: Out of the study population 70% of the patients had Oesophageal varices. Ultrasonography abdomen showed portal vein dilatation(>13mm) in 66.6% cases. The mean portal vein diameter in our study group was 13.1mm and majority of patients had portal vein between 13-13.9 mm (43.3%). A cut-off point of more than 13 mm had strong significant relationship (p<0.01) with presence of esophageal varices (sensitivity of 100%, specificity of 90% and positive predictive value of 95.24%). Higher grades of esophageal varices exists with larger portal vein size.Conclusions: From present study, authors conclude that portal vein size and its dilatation detected ultrasonographically can determine the presence of esophageal varices and can hence identify the subset of patients who require endoscopy for the prophylactic management of variceal bleeding. Therefore, reduce the burden on the endoscopy units, avoiding unnecessary screening endoscopies. Apart from being non-invasive, portal vein diameter is a relatively inexpensive and easily reproducible parameter.

scholarly journals Increased Portal Vein Diameter is Predictive of Portal Vein Thrombosis Development in Patients with Liver Cirrhosis

2020 ◽  
Author(s):  
Gang Dong ◽  
Xiaoquan Huang ◽  
Yuli Zhu ◽  
Hong Ding ◽  
Feng Li ◽  
...  
Keyword(s):  
High Risk ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Hepatic Decompensation ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
B Virus ◽  
Vein Diameter ◽  
Cirrhotic Patients ◽  
Study Participants

Abstract Background: Cirrhotic patients with portal vein thrombosis (PVT) may have a high risk of hepatic decompensation and increased mortality. This study aimed to investigate if increased portal vein diameter is associated with PVT development.Methods: A total of 174 cirrhotic patients were enrolled between February 1 and August 31, 2017. All participants were divided into PVT (n=62) and non-PVT (n=112) groups based on the thrombus that was detected by ultrasonography and confirmed by computed tomography angiography (CTA).Results: The study participants, aged 54.7±10.5 years (PVT) and 55.8±11.6 years (non‑PVT), were included in this analysis. The Child-Pugh score of PVT or non‑PVT was 6.6±1.3 and 5.8±0.9, respectively. Hepatitis B virus (HBV) is the primary etiological agent of cirrhosis. Logistic regression, receiver operating characteristic (ROC), and nomograph analysis designated portal diameter as the strongest independent risk factor for predicting PVT development (odds ratio (OR): 3.96, area under the ROC curve (AUC): 0.88;P<0.01), and the cutoff with predictive value for PVT development was >12.5 mm. No differences were observed in the overall survival (OS) in cirrhosis with or without PVT or stratifying on portal diameter based on the cutoff value.Conclusions: Increased portal diameter is associated with an increased risk of PVT development. Patients with cirrhosis and increased portal diameter are a high-risk subgroup that may need thromboprophylaxis.

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