scholarly journals To Study the Association between Splenic Size and Grades of Oesophageal Varices in Patients of Cirrhosis of Liver with Portal Hypertension

2020 ◽  
Vol 9 (13) ◽  
pp. 1022-1025
Author(s):  
Priyadarshi B. P ◽  
Imran Kamal Khan ◽  
Vinay Kumar ◽  
Ashok Kumar Verma ◽  
Tanu Midha ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Oesophageal Varices ◽  
Cirrhosis Of Liver ◽  
Splenic Size

scholarly journals Platelet Count/Splenic Diameter Ratio to Predict Oesophageal Varices in Portal Hypertension

2019 ◽  
Vol 2 (2) ◽  
pp. 192-196
Author(s):  
Buddhi Sagar Lamichhane ◽  
Manoj Koirala ◽  
Bishwo Raj Baral
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Rural Areas ◽  
Predictive Value ◽  
Tertiary Hospital ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Cirrhosis Of Liver

Background: One of the major causes of morbidity and mortality in Nepal is portal hypertension due to liver cirrhosis. In rural areas where a lot of cases of cirrhosis of liver are prevalent and endoscopic expertise and facilities are not available, predicting the presence of esophageal varices through non-invasive means may reduce a large number of unnecessary endoscopies. This study is to identify the relationship of platelet count /splenic bipolar diameter ratio with the presence of esophageal varices in portal hypertension. Materials and methods: Eighty patients were included in this study between Jestha 2072 to Baisakh 2073 with the diagnosis of portal hypertension admitted in Bir hospital, Kathmandu which is a tertiary hospital of government of Nepal, which were mostly due to liver cirrhosis. The patients fulfilling the inclusion criteria underwent lab investigations, ultra sonogram and UGI endoscopy. The data were assessed for descriptive studies and means were compared using t-test. The cut off value of platelet count to spleen diameter ratio of 1150 was used to predict the presence or absence of oesophageal varices. Statistical analysis was done using SPSS 20 software Results: Platelet count to splenic diameter ratio with a cut off value of 1150 has sensitivity of 89.7%, specificity of 83.3%, positive predictive value of 96.8% and negative predictive value of 58.8% (p= 0.002, CI=95%) with 89.5 % accuracy. Conclusion: Platelet count to splenic bipolar diameter ratio can be a good predictor of presence of esophageal varices in patients with portal hypertension in the resource poor settings.

scholarly journals CORRELATION OF PORTAL VEIN DIAMETER AND SPLENIC SIZE WITH OESOPHAGEAL VARICES IN CIRRHOSIS OF LIVER

2017 ◽  
Vol 6 (82) ◽  
pp. 5746-5749 ◽  
Author(s):  
Rina Mohanty ◽  
Namita Mohapatra ◽  
Ashish Malla ◽  
Jitendra Naik ◽  
Bijendra Mohanty ◽  
...  
Keyword(s):  
Portal Vein ◽  
Oesophageal Varices ◽  
Vein Diameter ◽  
Cirrhosis Of Liver ◽  
Splenic Size

Spectrum of upper gastrointestinal bleed in patients with cirrhosis of liver

2017 ◽  
Vol 13 (3) ◽  
pp. 318-322
Author(s):  
Subash Bhattarai ◽  
Khus Raj Dewan ◽  
Gaurav Shrestha ◽  
Bhanumati Saikia Patowary
Keyword(s):  
Liver Cirrhosis ◽  
Peptic Ulcer ◽  
Portal Hypertension ◽  
Oesophageal Varices ◽  
Gastrointestinal Bleed ◽  
Variceal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
Cirrhotic Patients ◽  
Cirrhosis Of Liver ◽  
Upper Gastrointestinal

Background & Objectives:Acute upper gastrointestinal (UGI)  bleeding is a serious medical problem in patients with cirrhosis of  liver associated with high mortality. Gastro-oesophageal variceal bleed is the most common complication of portal hypertension in patient with liver cirrhosis. This study  was undertaken to establish the causes of UGI bleed in cirrhosis, their relative incidences, clinical presentation , endoscopic findings, outcomes during hospitalization including rebleeding and mortality were studied.Materials & Methods:One hundred and twenty patients with clinical features, sonological and endoscopic evidence of portal hypertension and cirrhosis of liver who presented with upper gastrointestinal bleed were included in the study. After haemodynamic stability, each patient underwent UGI endoscopy usually within 12 hours and the aetiology with diagnostic findings were documented. Results:Ruptured oesophageal varices was the  most common cause of UGI bleed in cirrhotic patients. Non variceal causes of UGI bleed accounted for 33.3 % of cases. The majority of non variceal bleed was peptic ulcer disease and accounted for 19.2 % of total UGI bleed in liver cirrhosis. This was followed by portal hypertension gastropathy, erosive gastropathy, mallory-weiss tear and others.Conclusion:The most frequent causes of acute gastrointestinal bleeding in cirrhosis was  oesophageal varices. Peptic ulcer disesase is also a common aetiology of UGI bleed in cirrhosis. Cirrhotic patients with variceal etiology have more chances of rebleeding and have higher mortality than those with non variceal aetiologies. 

scholarly journals Peptic Ulcer Diseases in Patients with Liver Cirrhosis and Portal Hypertension: Experience in a Tertiary Level Hospital in Bangladesh

2021 ◽  
Vol 16 (2) ◽  
pp. 68-71
Author(s):  
Ahmed Lutful Moben ◽  
Md Abdullahel Kafee ◽  
Md Jahangir Kabir ◽  
Arunanagshu Raha ◽  
Farjana Majid ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Peptic Ulcer ◽  
Portal Hypertension ◽  
Peptic Ulcer Disease ◽  
Oesophageal Varices ◽  
Portal Hypertensive Gastropathy ◽  
Class Iii ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Cirrhosis Of Liver

Introduction: Cirrhosis of liver and peptic ulcer disease (PUD) are very common in Bangladesh. PUD may coexist with cirrhosis and portal hypertension. Haematemesis and melaena in cirrhosis of liver are not always from ruptured oesophageal varices; rather it may be due to bleeding peptic ulcer disease. Objective: To find the prevalence of PUD among patients with liver cirrhosis and portal hypertension. Materials and Methods: This cross sectional, descriptive study was conducted on 96 patients of cirrhosis of liver diagnosed with oesophageal varices at endoscopy unit of Kurmitola general hospital, during endoscopic evaluations in 4 months period from september 2017 to december 2017. Results: Total cirrhotic patients enrolled were 96 (M=61, F=35), mean age was 51.8 ± 14.2 yrs (18-86years). Hepatitis B virus (HBV) was the leading cause of cirrhosis in 54.1%, Hepatitis C virus (HCV) 5.2 %, proven non-alcoholic steatohepatitis (NASH) were 11.5% and rest were from unknown aetiology. Their average Child-Turcotte-Pugh (CTP) score were 8.6 (12-5), 37.6% associated with portal hypertensive gastropathy. Grade-III oesophageal varices found in 52 patients, whereas grade-II in 25 patients. Among this 96 patients 39 (40.6%) revealed peptic ulcer disease more in the form of gastric ulcer (n=23) than duodenal ulcer (n=10) and both (n=6). Most of the ulcers belonged to Forrest class III (76.9%). Conclusions: Variceal bleeding and portal hypertensive gastropathy are the common causes of bleeding and anaemia in patients with cirrhosis of liver. Peptic ulcer disease has been found to be one of the potential causes of haematemesis, melaena, and anaemia among these patients in Bangladesh. Large multicenter controlled studies are needed to confirm the reports. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 68-71

scholarly journals Non-Invasive Predictors of Gastro-Oesophageal Varices

2017 ◽  
Vol 56 (207) ◽  
pp. 298-303 ◽  
Author(s):  
Subash Bhattarai ◽  
Khus Raj Dewan ◽  
Gaurav Shrestha ◽  
Bhanumati Saikia Patowary
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Serum Albumin ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal Endoscopy ◽  
Spleen Size ◽  
Non Invasive ◽  
Vein Diameter ◽  
Cirrhosis Of Liver

Introduction: The worldwide accepted tool for screening and monitoring gastro-oesophageal varices in patients with liver cirrhosis is upper gastrointestinal endoscopy. Endoscopy needs clinical expertise and has got its own procedure related complications. Repeated endoscopies may be expensive and patients tend to develop poor compliance. This study was undertaken to establish the role of noninvasive parameters in predicting gastro-esophageal varices. Methods: Two hundred patients with clinical features, laboratory and sonological findings suggestive of cirrhosis of liver and endoscopic evidence of portal hypertension were included in the study. Blood parameters like serum albumin, international normalized ratio (INR), platelets count and ultrasonography assessments of portal vein diameter and spleen size were compared with presence of gastro-oesophageal varices. Results: At cutoff point of 2.55g/dl, serum albumin had high specificity of 99% whereas platelets count <1,44,000/mm3 had 87.9% sensitivity for presence of oesophageal varices. Sensitivities of 92.72% and 94.5% while specificities of 90% and 75% were detected for presence of oesophageal varices when the cutoff values for portal vein diameter and spleen size were 12.25 mm and 13.9 cm respectively. Conclusions: Measurements of serum albumin, platelets count, portal vein diameter and spleen size by ultrasonography can be recommended as a non-invasive predictor for gastro-oesophageal varices in cirrhosis of liver. All these non-invasive parameters could be useful to patients with liver cirrhosis with portal hypertension in predicting presence of varices as well as in long-term clinical monitoring and management. Keywords: cirrhosis of liver; endoscopy; gastro-oesophageal varices; non-invasive predictors.

scholarly journals Study the association between platelets count and grades of oesophageal varies in patients of cirrhosis of liver with portal hypertension

2020 ◽  
Vol 7 (4) ◽  
pp. 603
Author(s):  
B. P. Priyadarshi ◽  
Imran Kamal Khan ◽  
Vinay Kumar ◽  
Ashok Kumar Verma ◽  
Tanu Midha ◽  
...  
Keyword(s):  
Platelet Count ◽  
Portal Hypertension ◽  
Statistical Analysis ◽  
Esophageal Varices ◽  
Beta Blockers ◽  
Oesophageal Varices ◽  
P Value ◽  
Screening Endoscopy ◽  
Grade 3 ◽  
Cirrhosis Of Liver

Background: cirrhosis of liver is a diffuse process of fibrosis that converts the liver architecture into structurally abnormal nodules Portal hypertension leads to dilatation of portal vein, splenomegaly, and formation of portal systemic collaterals at different sites. Screening endoscopy is recommended for early detection of esophageal varices (EVs) in cirrhotic patients with portal hypertension. However, this approach is limited by its invasiveness and cost. The aim of the study was to determine if platelet count can predict the presence of EVs, especially large (grade III, IV) EVs in need of prophylactic therapy.Methods: Statistically 100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were selected for the study. Ultrasonography was performed in all cases to note the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was done to detect presence of varices with grades. Statistical Analysis: Statistical analysis was done using Statistical Package for Social Survey (SPSS) for Windows version 17.0. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient, p value <0.05 was considered significant.Results: Among 100 patients studied ,90% patients were found to have esophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 esophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of platelet count with grades of esophageal varices it was evident that 44 patients had their platelet count less than 1 lac out of which 24 patients had grade 2 varices followed by 14 patients with grade 3 varices, p value <0.001 and was highly significant.Conclusions: The study depicts that with decrease in platelets count the chances of formation of higher grades of oesophageal varices increases and also a positive association exists.

Non-invasive methods in the assessment of portal hypertension severity

2021 ◽  
Vol 75 (2) ◽  
pp. 125-133
Author(s):  
Soňa Franková ◽  
Jan Šperl
Keyword(s):  
Portal Hypertension ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Invasive Technique ◽  
Hepatic Veins ◽  
Oesophageal Varices ◽  
Non Invasive

Portal hypertension represents a wide spectrum of complications of chronic liver diseases and may present by ascites, oesophageal varices, splenomegaly, hypersplenism, hepatorenal and hepatopulmonary syndrome or portopulmonary hypertension. Portal hypertension and its severity predicts the patient‘s prognosis: as an invasive technique, the portosystemic gradient (HPVG – hepatic venous pressure gradient) measurement by hepatic veins catheterisation has remained the gold standard of its assessment. A reliable, non-invasive method to assess the severity of portal hypertension is of paramount importance; the patients with clinically significant portal hypertension have a high risk of variceal bleeding and higher mortality. Recently, non-invasive methods enabling the assessment of liver stiffness have been introduced into clinical practice in hepatology. Not only may these methods substitute for liver biopsy, but they may also be used to assess the degree of liver fibrosis and predict the severity of portal hypertension. Nowadays, we can use the quantitative elastography (transient elastography, point shear-wave elastrography, 2D-shear-wave elastography) or magnetic resonance imaging. We may also assess the severity of portal hypertension based on the non-invasive markers of liver fibrosis (i.e. ELF test) or estimate clinically signifi cant portal hypertension using composite scores (LSPS – liver spleen stiff ness score), based on liver stiffness value, spleen diameter and platelet count. Spleen stiffness measurement is a new method that needs further prospective studies. The review describes current possibilities of the non-invasive assessment of portal hypertension and its severity.

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