scholarly journals Correlation of portal vein diameter, splenomegaly and thrombocytopenia with gastro-espohageal varices in cirrhotic patients

2017 ◽  
Vol 4 (12) ◽  
pp. 38-44
Author(s):  
Inderpal Singh ◽  
◽  
Rishabh Sehgal ◽  
Harsimranjit Singh ◽  
Puneet Chuchra ◽  
...  
Keyword(s):  
Portal Vein ◽  
Vein Diameter ◽  
Cirrhotic Patients

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.

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 Portal vein thrombosis in cirrhotic patients - it is always the small pieces that make the big picture

2018 ◽  
Vol 24 (39) ◽  
pp. 4419-4427 ◽  
Author(s):  
Irina Gîrleanu ◽  
Anca Trifan ◽  
Carol Stanciu ◽  
Cătălin Sfarti
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Vein Thrombosis ◽  
Big Picture ◽  
Cirrhotic Patients

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

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 No Association of Homocysteine, Anticardiolipin Antibody, and Anti-β2 Glycoprotein I Antibody With Portal Venous System Thrombosis in Liver Cirrhosis

2021 ◽  
Vol 27 ◽  
pp. 107602962110109
Author(s):  
Le Wang ◽  
Xiaozhong Guo ◽  
Xiangbo Xu ◽  
Shixue Xu ◽  
Juqiang Han ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Anticardiolipin Antibody ◽  
Venous System ◽  
Common Complication ◽  
Portal Venous System ◽  
Main Portal Vein ◽  
Glycoprotein I ◽  
Cirrhotic Patients ◽  
Clinically Significant

Portal venous system thrombosis (PVST), a common complication of liver cirrhosis, is closely associated with thrombophilia. To explore the association of homocysteine (Hcy), anticardiolipin antibody (aCL), and anti-β2 glycoprotein I antibody (aβ2GPI), which are possible thrombophilic factors, with PVST in liver cirrhosis. Overall, 654 non-malignant patients (219 with and 435 without liver cirrhosis) admitted between January 2016 and June 2020 were retrospectively evaluated. Presence of PVST, degree of main portal vein (MPV) thrombosis, and clinically significant PVST were identified. Hcy level, hyperhomocysteinemia (HHcy), aCL positivity, and aβ2GPI positivity were compared according to the presence of liver cirrhosis and PVST. Positive aβ2GPI was significantly more frequent in patients with liver cirrhosis than those without, but Hcy level and proportions of HHcy and positive aCL were not significantly different between them. PVST could be evaluated in 136 cirrhotic patients. Hcy level [10.57 μmol/L (2.71-56.82) versus 9.97 μmol/L (2.05-53.44); P = 0.796] and proportions of HHcy [4/44 (9.1%) versus 13/81 (16.0%); P = 0.413] and positive aCL [1/23 (4.3%) versus 10/52 (19.2%); P = 0.185] and aβ2GPI [9/23 (39.1%) versus 21/52 (40.4%); P = 0.919] were not significantly different between cirrhotic patients with and without PVST. There was still no significant association of Hcy level, HHcy, aCL, or aβ2GPI with PVST based on Child-Pugh classification, MPV thrombosis >50%, and clinically significant PVST. Hcy, aCL, and aβ2GPI may not be associated with PVST in liver cirrhosis, suggesting that routine screening for Hcy, aCL, and aβ2GPI should be unnecessary in such patients.

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