scholarly journals Study of the correlation of oesophageal varices with portal vein diameter and ratio of platelet count to splenic diameter and their comparative evaluation in liver cirrhosis

2021 ◽  
Vol 8 (9) ◽  
pp. 1405
Author(s):  
Harpreet Singh ◽  
Sidharth Sharma ◽  
Gurminder Singh ◽  
Dania Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Vein ◽  
Comparative Evaluation ◽  
Significant Negative Correlation ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Non Invasive ◽  
Vein Diameter ◽  
The Mean

Background: The aim of the study was to determine the correlation of oesophageal varices (OV) with portal vein diameter and the platelet count to splenic diameter ratio and their comparative evaluation in patients of liver cirrhosis.Methods:The present study consisted of 50 patients diagnosed with liver cirrhosis. Necessary investigations were performed in all the patients including Upper gastrointestinal (GI) endoscopy. Platelet count/spleen diameter ratio, spleen diameter and portal vein diameter were calculated for all patients and the presence and grading of OV was then comparatively evaluated. The results were systematically recorded and statistically analysed.Results: The mean age of patients was 49.82±10.23 years. 78% of patients presented with OV. The portal vein diameter, platelet count, spleen diameter and platelet count/spleen diameter ratio were significantly increased in patients with OV than those without OV (p<0.0001). Highly significant positive correlation between portal vein diameter, spleen diameter and grading of OV was seen. Platelet count/spleen diameter ratio and platelet count was significantly decreased as the grade of OV increased in the patients. There was statistically, a highly significant negative correlation between them.Conclusions: The non-invasive parameters used to detect presence of OV in liver cirrhosis were portal vein diameter and platelet count/spleen diameter ratio. Though, both seemed to be effective in predicting OV, platelet count/spleen diameter ratio proved to be slightly more significant when compared to the other. 

scholarly journals Role of Ultrasonography in Predicting Gastro-oesophageal Varices in Patients with Liver Cirrhosis

2021 ◽  
Vol 17 (1) ◽  
pp. 10-15
Author(s):  
Merina Gyawali ◽  
Ramesh Raj Acharya
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal System ◽  
Oesophageal Varices ◽  
Spleen Size ◽  
Cross Sectional ◽  
Non Invasive ◽  
The Social ◽  
Vein Diameter ◽  
Splenic Size

IntroductionUpper Gastrointestinal endoscopy is considered the best screening tool in detecting gastroesophagealvarices in patients with cirrhosis. Ultrasonography of the abdomen can be used forassessment of liver and portal system. This research was undertaken to demonstrate that theportal vein diameter and splenic size by ultrasonography can be used as a non-invasive predictorof gastro-esophageal varices. MethodsA cross-sectional hospital based study comprising of 290 consecutive patients with liver cirrhosiswere enrolled between November 2019 to November 2020. Clinical profile at admission andsonological splenic size and portal vein diameter were studied in all cirrhotic patients. Patientswere classified into 2 groups: one with presence of varices and second without varices. Data entrywas done in Statistical Packages for the Social Sciences version 20. ResultsThe mean age of subjects was 52±13.26 years with a range of 27 – 82 years of age (M:F=2:1). Thecommonest etiology of cirrhosis was chronic alcohol consumption. The prevalence of varices incirrhotics was 42.8%. Average portal vein diameter of patients without gastro-esophageal variceswas 11.12 ± 1.36 mm, while it was 12.81 ± 1.62 mm in patients with varices (p < 0.001). Averagespleen size in cirrhotics without varices was 12.44 ± 1.32 cm and with varices was 14.32 ± 2.42 cm.This difference was also statistically significant (p < 0.001). ConclusionsMeasurement of portal vein diameter and spleen size by ultrasonography can be recommendedas a non invasive predictor for gastro-oesophageal varices in patients with liver cirrhosis . Keywords: cirrhosis; portal vein diameter; spleen size; ultrasonography; gastro-oesophageal varices

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 OF PLATELET COUNT-SPLEEN DIAMETER RATIO AS A NON-INVASIVE PREDICTOR OF OESOPHAGEAL VARICES IN PATIENTS WITH CIRRHOSIS OF LIVER

2018 ◽  
Vol 5 (2) ◽  
pp. 132-134
Author(s):  
Noas Tobias Minz ◽  
Ganeswar Sethy ◽  
Arjun Kuttikrishnan ◽  
Teena Thomas ◽  
Abinash Swain ◽  
...  
Keyword(s):  
Platelet Count ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Non Invasive ◽  
Cirrhosis Of Liver

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

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 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.

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