scholarly journals Oesophageal varices, portal hypertensive gastropathy and spontaneous Sub-arachnoid haemorrhage in a case of liver cirrhosis diagnosed on autopsy.

2021 ◽  
Vol 9 (3) ◽  
Author(s):  
Luv Sharma ◽  
Pardeep Yadav ◽  
Mahender Singh
Keyword(s):  
Liver Cirrhosis ◽  
Risk Factor ◽  
Esophageal Varices ◽  
Chronic Alcoholism ◽  
Oesophageal Varices ◽  
Portal Hypertensive Gastropathy ◽  
Chronic Alcoholic ◽  
Male Individual ◽  
Autopsy Examination ◽  
Arachnoid Hemorrhage

Alcohol remains one of the most abused substances worldwide. Studies over the years have attributed chronic alcoholism as a major risk factor to liver cirrhosis. Patients with liver cirrhosis develop portal hypertension which put them at a higher risk of having esophageal varices and other associated complications. The authors present a case of a chronic alcoholic male individual who developed cirrhosis along with other less reported complications like sub-arachnoid hemorrhage and portal hypertensive gastropathy. The paper also profiles various changes associated with esophageal varices as observed during autopsy examination.

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 CIRRHOTIC PATIENTS;

2013 ◽  
Vol 20 (06) ◽  
pp. 876-881
Author(s):  
MUHAMMAD ADNAN BAWANY ◽  
JAHANGIR LIAQUAT ◽  
MUHMMAD AKBER ◽  
Falak Naz ◽  
Shereen Rahat Khanzada ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
University Hospital ◽  
Oesophageal Varices ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Hospital Design ◽  
Upper Gi ◽  
Predicting Factors ◽  
Cirrhotic Patients

Objective: To determine the frequency of upper GI bleeding and its predicting factors and esophageal varices in the patientswith liver cirrhosis disease admitted at medicine ward of Isra university hospital. Design: Prospective and observational study. Setting:Isra university hospital. Period: March 2012 to August 2012 (six months). Methods: Containing 100 patients, mean age was 45.8, and allthe patients with cirrhosis disease were included in this study with liver cirrhosis disease. All patients were under went endoscopy andFrequency of upper GI bleeding and varices presentation and classification according to grade were noted. Results: All the 100 patientswere selected on the basis of presenting liver cirrhosis disease. Male were more found than the female with the mean age 45.8. Mostlycirrhotic patients were found with HCV positive and upper GI bleeding were noted in (40%) of the cases. With the endoscopic findingmostly patients were noted in ll - lll grad of esophageal varices and according to child pug classification majority of patients was noted inclass “C” In addition, thrombocytopenia and red wale markings along with the presence of large sized varices were associated with thepresence of esophageal varices. Conclusions: In the conclusion of this study we found majority of the cirrhotic patients with HCV,Esophageal varices and thrombocytopenia are the important factors of upper GI bleeding. Knowledge and etiology of this manuscript mayhelpful in the prevention of oesophageal varices and upper GI bleeding.

scholarly journals A study on non endoscopic predictors of esophageal varices and portal hypertension in chronic liver disease

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 228-234
Author(s):  
Karthick M ◽  
Prabakaran P T ◽  
Rajendran K ◽  
Gowrishankar A ◽  
Halleys Kumar E ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Chronic Liver ◽  
First Episode ◽  
Oesophageal Varices ◽  
Screening Endoscopy

Portal hypertension is associated with liver cirrhosis and esophageal varices is a common complication. Cirrhotic liver increases resistance to the passage of blood and thereby increased splanchnic blood flow secondary to vasodilation. Prevalence of portal hypertension varies from 50-60% in patients with liver cirrhosis. The first episode of variceal bleeding causes mortality, which ranges from 40-70%. All cirrhotic patients should be screened for the oesophageal varices according to  Baveno III consensus conference on portal hypertension and recommendation for endoscopy is at 2-3 years intervals in patients without varices and at 1-2 years interval in patients with small varices in order to evaluate the development or variceal progression. But this is questionable as endoscopy is an invasive procedure and also cost-effective. Only 9-36% of patients with cirrhosis were found to have varices on screening endoscopy. Non-invasive assessment of variceal bleeding with good predictivity includes biochemical, clinical and ultrasonographic parameters. Thus unnecessary intervention is avoided and at the same time, the patients at risk of bleeding are also not missed. This study emphasizes the need for an annual ultrasonogram examination as a part of a surveillance program for screening of oesophageal varices in patients of chronic liver disease.

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 Clinical Profile and Upper Gastrointestinal Endoscopic Findings of Patients Presenting with Liver Cirrhosis with Portal Hypertension

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Shatdal Chaudhary ◽  
Niraj Kumar Jaiswal ◽  
Aakash Shahi ◽  
Pradip Chhetri
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Clinical Profile ◽  
Upper Gastrointestinal Endoscopy ◽  
Portal Hypertensive Gastropathy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

Introduction: Liver cirrhosis is a common problem faced by physicians worldwide and is also responsible for 11th most common cause of death globally. Data regarding prevalence of esophageal varices and other upper gastrointestinal changes in patients with liver cirrhosis is scare in Nepal. So this study was carried out to find clinical profile and upper gastrointestinal endoscopic findings of patients presenting with liver cirrhosis with portal hypertension. Methods: This was a cross-sectional observational hospital based study conducted in the department of internal medicine and endoscopy unit of the Universal College of Medical Sciences, Bhairahawa, Nepal. The study was done from 21 February 2019 to 20 November 2019 in the patients presented with liver cirrhosis with portal hypertension. Sample size of 80±10 was calculated based on the statistics of previous data. The upper gastrointestinal endoscopy was done in all the patients. The data was collected using the predesigned pro-forma. Results: Total 89 patients with liver cirrhosis were enrolled with mean age of 51.84±12.26 years and male: female ratio of 3.68:1. As per Child Pugh classification (CTP) 45 patients (51%) were in Class C, 33 patients (37%) were in Class B and 11 patients (12%) were in Class A. Esophageal varices were present in 51 (57.3%) patients. According to Westaby classification grade I esophageal varices were seen in 17 (19.1%), grade II esophageal varices were seen in 26 (29.2%), grade III esophageal varices were seen in 8 (8.9%) patients. Portal hypertensive gastropathy (PHG) was seen in 64 (71%) patients. The association between esophageal varices and PHG grade was found statistically significant (P= <0.001). Conclusions: Liver cirrhosis was more commonly seen in middle age males. Esophageal varices and portal hypertensive gastropathy were common endoscopic findings present in patients with liver cirrhosis. There was statistically significant association between esophageal varices and PHG.

Transient elastography to rule out esophageal varices and portal hypertensive gastropathy in HIV-infected individuals with liver cirrhosis

AIDS ◽  
2012 ◽  
Vol 26 (14) ◽  
pp. 1807-1812 ◽  
Author(s):  
Maria L. Montes Ramirez ◽  
Jose F. Pascual-Pareja ◽  
Matilde Sánchez-Conde ◽  
Jose I. Bernardino De la Serna ◽  
Francisco X. Zamora Vargas ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Portal Hypertensive Gastropathy ◽  
Rule Out

scholarly journals Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis

2017 ◽  
Vol 5 (3) ◽  
pp. 169-173 ◽  
Author(s):  
Rajesh Mandhwani ◽  
Farina M. Hanif ◽  
Muhammad Manzoor Ul Haque ◽  
Rajesh Kumar Wadhwa ◽  
Nasir Hassan Luck ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Abdominal Ultrasound ◽  
Portal Hypertensive Gastropathy ◽  
Clinical Predictors ◽  
Liver Lobe ◽  
Cross Sectional ◽  
Gi Endoscopy

AbstractBackground and ObjectivesPortal hypertensive gastropathy (PHG) is described endoscopically as “mosaic-like appearance” of gastric mucosa with or without the red spots. It can only be diagnosed by upper gastrointestinal (GI) endoscopy. The aim of this study was to determine the diagnostic accuracy of platelet count to spleen diameter ratio (PSR) and right liver lobe diameter to albumin ratio (RLAR) in the detection of PHG using upper GI endoscopy as a gold standard in patients with liver cirrhosis.Material and MethodsThis cross-sectional study was conducted in the Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi. All consecutive patients with ages 18–65 years who were screened using esophagogastroduodenoscopy (EGD) to exclude esophageal varices were enrolled. At the same time, findings related to PHG were noted. After informed consent, all the patients had blood tests including platelet count and albumin and abdominal ultrasound determining spleen diameter and right liver lobe diameter.ResultsOut of 111 patients, 59 (53.15%) were males with a mean age of 44 ± 12.61 years. Rate of PHG was observed in 84.68% (94/111) cases confirmed by EGD. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PSR were 87.23%, 5.88%, 83.67%, 7.69%, and 74.7%, respectively, and those of RLAR were 28.72%, 70.59%, 84.38%, 15.19%, and 35.14%, respectively.ConclusionPSR is better predictor of PHG than RLAR but at the expense of relatively lower specificities and NPV likely because of underlying pathophysiology (portal hypertension) which is similar for esophageal varices, PHG, and ascites.

scholarly journals To determine the correlation between mean platelet count and frequency of grading of esophageal varices in patients of liver cirrhosis.

2021 ◽  
Vol 28 (06) ◽  
pp. 833-841
Author(s):  
Masood Javed ◽  
Dilshad Mohammad ◽  
Zain Masood ◽  
Ghulam Abbas Sheikh ◽  
Muzammal Iftikhar ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Oesophageal Varices ◽  
P Value ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
Grade Ii ◽  
The Mean ◽  
Grade Iii

Objectives: To determine the correlation between mean platelet count and grading of esophageal varices in patients of liver cirrhosis. Study Design: Cross Sectional study. Settings: Department of Medicine, DHQ Hospital (FMU) &AFM&DC Faisalabad. Period: 17th August 2019 to 16th February 2020. Material & Methods: A total of 105 patients liver cirrhosis with esophageal varices were included in the study according to the inclusion and exclusion criteria. For assessment of platelet count 2ml blood sample was sent to hospital pathology laboratory and it was reported by the pathologist. Upper GI endoscopy was performed by gastroenterologist for confirmation and grading of oesophageal varices. Results: In our study, it was observed that 04 (3.81%) patients had grade- I EV, 34 (32.38%) Grade-II, 39 (37.14%) Grade III, 15 (14.29%) Grade IV and 13 (12.38%) patients had Grade V esophageal varices. While correlating the mean platelet count and grading of esophageal varices in patients of liver cirrhosis, it was observed that the mean platelet count of the patients with Grade-I EV was 149000± 26000, platelet count in patients with Grade-II EV was 122000 ± 26000, platelet count in patients with Grade-III EV was 100000 ± 23000, platelet count in patients with Grade-IV EV was 98000 ± 26000 and platelet count in patients with Grade-V EV was 94000 ± 22000 with correlation r value of 0.370 and p-value of 0.0001 which is statistically significant. Conclusion: This study concluded that there is inverse correlation between mean platelet count and grades of esophageal varices in patients of liver cirrhosis.

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