scholarly journals Role of Serum Ascites Albumin Gradient (SAAG) and Portal Vein Congestion Index as Non-‎Invasive Methods for Prediction of Esophageal Varices in Cirrhotic Patients ‎

2021 ◽  
Vol 0 (0) ◽  
pp. 270-283
Author(s):  
Gamal Eldeeb ◽  
Shimaa Hassanein ◽  
Ibrahim Abd-Elmawla ◽  
Naglaa Elabd
Keyword(s):  
Portal Vein ◽  
Esophageal Varices ◽  
Non Invasive ◽  
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 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 Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis

2015 ◽  
Vol 17 (1) ◽  
pp. 5 ◽  
Author(s):  
Adriana Bintintan ◽  
Romeo Ioan Chira ◽  
Vasile Virgil Bintintan ◽  
Georgiana Nagy ◽  
Roberta Maria Manzat-Saplacan ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Statistical Power ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Abdominal Ultrasound ◽  
Non Invasive ◽  
Cirrhotic Patients ◽  
Ultrasound Parameters

Aims: Non-invasive methods are required to diagnose presence and grading of esophageal varices in patients with he- patic cirrhosis and in this respect we have evaluated the role of transient elastography and abdominal ultrasound parameters. Material and methods: Cirrhotic patients were prospectively evaluated by transient elastography and Doppler ultrasound for diagnosis of presence and grading of esophageal varices, the results being compared with the findings of the esophagogas- troduodenoscopy. Results: Sixty patients with hepatic cirrhosis were analysed. The parameters that reached statistical signifi- cance for diagnosis of esophageal varices were: liver stiffness (LSM) > 15 kPa, hemodynamic liver index (PVr1) ≥ 0.66, portal vascular resistance (PVR) > 17.66 and splenoportal index (SPI) > 4.77. The only parameter that reached statistical power for the diagnosis of large esophageal varices was LSM at a cut-off value of 28.8 kPa. Conclusions: Assessment of LSM in patients with liver cirrhosis can predict both the presence of esophageal varices and of large esophageal varices. The PVr1, PVR and SPI Doppler indexes can be used to diagnose the presence of esophageal varices but have no role in the prediction of large esophageal varices. Further studies are required to confirm these results and offer a stronger clinical significance.

scholarly journals Evaluation of the Gallbladder Wall Thickening as a Non-invasive Predictor of Esophageal Varices in Cirrhotic Patients

2021 ◽  
pp. 1-9
Author(s):  
Nora M. Shehata ◽  
Alsiagy A. AbdelAziz ◽  
Medhat Abd El-Megid ◽  
Yasser M. Hafez
Keyword(s):  
Gall Bladder ◽  
Portal Vein ◽  
Wall Thickness ◽  
Esophageal Varices ◽  
Bladder Wall ◽  
Wall Thickening ◽  
P Value ◽  
Bladder Wall Thickness ◽  
Non Invasive ◽  
Cirrhotic Patients

Background: Liver cirrhosis represent the end stage of fibrosis that destroy normal liver parenchyma and leads to serious complication as portal hypertension which result in esophageal varices (EV), EV bleeding leads to high mortality, so repeated upper endoscopy needed to control bleeding which is invasive procedure and of high risk of hazards as infection. Our Study Aimed: to evaluate the Gallbladder Wall Thickening (GBWT) as a non-invasive predictor of Esophageal Varices (EV) in cirrhotic patients. Methods: In this cross sectional study, we tested 120 cirrhotic patients at gastroenterology and hepatology unit, internal medicine department, Tanta university hospitals. They were divided into 60 cirrhotic patients with EV and 60 cirrhotic patients without EV. All patients were subjected to history taking,  physical examination, investigation (complete blood count, liver function tests, viral markers) ultrasound detecting (gall bladder wall thickness, portal vein diameter, portal vein flow velocity, portal cross sectional area and gall bladder fasting volume) upper gastrointestinal endoscopy to detect presence or absence of varices. Results: Significant correlation was observed between gall bladder wall thickness (GBWT) and portal hypertension, GBWT ranged from 2.5 to 7 mm in group 2 (cirrhotic patients with EV) and from 1.5 to 5 in group 1( cirrhotic patients without EV). There is significant difference between group 1 and group 2 as regard GBWT with (P value < 0.05), portal vein diameter (PVD) with (P value <0.05) and platelets counts with (P value <0.05). Conclusions: We recommend thatgall bladder wall thickness can be used as a non-invasive predictor of esophageal varices in cirrhotic patients.

Non-invasive response prediction in prophylactic carvedilol therapy for cirrhotic patients with esophageal varices

2019 ◽  
Vol 70 (3) ◽  
pp. 412-422 ◽  
Author(s):  
Hwi Young Kim ◽  
Young Ho So ◽  
Won Kim ◽  
Dong-Won Ahn ◽  
Yong Jin Jung ◽  
...  
Keyword(s):  
Esophageal Varices ◽  
Response Prediction ◽  
Non Invasive ◽  
Cirrhotic Patients

scholarly journals Immature Platelet Fraction as a Non-Invasive Marker for Esophageal Varices

2021 ◽  
pp. 55-64
Author(s):  
Alyaa Marzouk Soliman ◽  
Sherief Mohamed Abd-Elsalam ◽  
Amal Saeid ALBendary ◽  
Osama El. Sayed Negm
Keyword(s):  
Esophageal Varices ◽  
Significant Positive Correlation ◽  
Oesophageal Varices ◽  
P Value ◽  
Positive Correlation ◽  
Non Invasive ◽  
Immature Platelet Fraction ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
Group 1

Background: All cirrhotic patients should be screened for oesophageal varices (OV) at the time of diagnosis. The development of a non-invasive method for the detection of OV is a vital issue in subjects with cirrhosis to decrease the need for invasive endoscopic procedures that can be costly. This work aimed to evaluate immature platelet fraction (IPF) as a non-invasive marker and predictor of OV. Methods: This cross-sectional study was carried out on 80 cirrhotic patients with esophageal varices diagnosed by upper endoscopy. They were divided into Group (1): 40 patients with cirrhosis with esophageal varices and Group (2): 40 patients with cirrhosis and without esophageal varices. All patients were subjected to the complete history taking, physical examination, routine laboratory investigations (Complete blood count, IPF, C-reactive protein, Liver and kidney function tests, Bone marrow aspiration for some cases, Ascetic sample analysis when applicable), Pelvic-Abdominal ultrasonography, Child Pugh score assessment, Upper GIT endoscopy. Results: There was a significant difference between the studied groups regarding IPF (p<0.001). At cutoff >12 IPF had (AUC= 0.993) with sensitivity of 97.5% and specificity of 97.5% for detection of esophageal varices. There was a significant negative correlation between IPF and platelets count (p- value < 0.001). There was a significant positive correlation between IPF and Child Pugh score (p- value <0.001). There was a highly significant positive correlation between IPF and CRP (p value <0.001). There was significant difference between the two groups as regards splenic longitudinal diameter (p<0.001). As regards platelet count, there was a significant difference between the two groups (p<0.001). It was significantly lower in Group 1. Conclusions: IPF is elevated in cirrhotic patients with naive esophageal varices than in cirrhotic patients without varices. IPF could be used as a noninvasive, easy to measure method for detection of the presence of esophageal varices at a cutoff level of >12.

Role of Serum Soluble CD163 in the Diagnosis, Risk of Bleeding, and Prognosis of Gastro-Esophageal Varices in Cirrhotic Patients

2017 ◽  
Vol 37 (3) ◽  
pp. 112-118 ◽  
Author(s):  
Rabab Fouad ◽  
Iman Hamza ◽  
Marwa Khairy ◽  
Marwa Elsharkawy ◽  
Amal A. Helmy
Keyword(s):  
Esophageal Varices ◽  
Risk Of Bleeding ◽  
Soluble Cd163 ◽  
Cirrhotic Patients

Non-Invasive Predictors of Esophageal Varices with a High Risk of Bleeding in Pediatric Cirrhotic Patients

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
José Ricardo Borém Lopes ◽  
Alexandre Rodrigues Ferreira ◽  
Priscila Menezes Ferri Liu ◽  
Thaís Costa Nascentes Queiroz ◽  
Eleonora Druve Tavares Fagundes ◽  
...  
Keyword(s):  
High Risk ◽  
Esophageal Varices ◽  
Non Invasive ◽  
Risk Of Bleeding ◽  
Cirrhotic Patients
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