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 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 A Study of Association of Portal Vein Diameter And Splenic Size With Gastro-Oesophageal Varices in Liver Cirrhosis Patients

2016 ◽  
Vol 15 (09) ◽  
pp. 125-129
Author(s):  
Dr. Ravi Shanker ◽  
Dr. S. Banerjee ◽  
Dr. Anshul ◽  
Dr. Sujata Ganguly ◽  
Dr. Saurav Bansal ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Oesophageal Varices ◽  
Vein Diameter ◽  
Splenic Size

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

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.

scholarly journals Significance of Non-Invasive Markers as Predictor of Esophageal Varices in Liver Cirrhosis

2017 ◽  
Vol 56 (208) ◽  
pp. 412-6 ◽  
Author(s):  
Dipendra Khadka ◽  
Sushil Prajapati ◽  
Sudhamshu KC ◽  
Jeetendra Kaji Shrestha ◽  
Niyanta Karki ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Clinical Expertise ◽  
Spleen Size ◽  
Cross Sectional ◽  
Cutoff Value ◽  
Non Invasive ◽  
Pugh Class

Introduction: Upper gastro-intestinal endoscopy remains the gold standard for screening for esophageal varices but it has its own limitations. It is an invasive, expensive and uncomfortable procedure and needs clinical expertise. Accordingly, this study was conducted to establish the role of non-invasive markers for prediction of esophageal varices in 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 test, liver ultrasound and upper gastro-intestinal endoscopy were done for all patients to detect esophageal varices and to correlate with different non-invasive markers. Results: Total 191 patients of liver cirrhosis were studied after exclusion. Platelet count of 92082.00±43435.83/mm3 and spleen size of 144.21±10.71 mm was found to be good predictors of presence of EV (P≤0.001). Significant association between Child-Turcotte-Pugh class and presence of varices was observed (P≤0.001). AST/ALT ratio with cutoff value of 1.415 showed sensitivity of 82.4% and specificity of 36.4%. APRI at a cutoff value of 1.3 showed a sensitivity of 83.2% and specificity of 50%. Conclusions: Platelet count, spleen size and Child-Turcotte-Pugh class are good predictors of presence of esophageal varices in patients with liver cirrhosis. AST/ALT ratio and APRI score are not good substitutes for upper gastro-intestinal endoscopy.   Keywords:  esophageal varices; liver cirrhosis; non-invasive markers; portal hypertension; upper gastro-intestinal.

scholarly journals ESOPHAGEAL VARICES;

2013 ◽  
Vol 20 (05) ◽  
pp. 653-660
Author(s):  
AHSAN AYUB
Keyword(s):  
Platelet Count ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Clinical Laboratory ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal Endoscopy ◽  
High Morbidity ◽  
Cross Sectional ◽  
Need To Evaluate ◽  
Vein Diameter

Bleeding from esophageal varices is associated with high morbidity and mortality. It is currently recommended that allpatients with liver cirrhosis undergo upper gastrointestinal endoscopy to identify those who have esophageal varices. This approachleads to unnecessary endoscopies. There is need to evaluate clinical, laboratory and imaging parameters that may predict the presence ofesophageal varices and help select patients for endoscopy. Objective: Identify hematological, biochemical and ultasonographicpredictors of oesophageal varices in patients of cirrhosis. Study design: Cross sectional Descriptive study. Setting: Department ofGeneral Medicine and Gastroenterology unit 1, Services Hospital, Lahore. Duration of study: 6 months (April 01, 2007 – September 30,2007). Sample size: Study was done on One hundred patients who had established cirrhosis with oesophageal varices. Results: Majority(77%) were male who had evidence of esophageal varices. Hematemesis was the presenting complaint in 75% of patients and majority(83%) had clinically palpable spleen. Esophageal varices were present in 75% of patents who had platelet count <100, 000. In patientswho had portal vein diameter of >20mm 41% had evidence of esophageal varices. Splenic measurement of >13cm was associated withmaximum number of cases of esophageal varices i.e 82%. Conclusion: It is concluded from the study that male gender, clinically palpablespleen, low platelet count, portal vein diameter and splenic measurement can be used as non invasive parameters to predict esophagealvarices reducing the need of unnecessary endoscopies.

scholarly journals Are non invasive predictors of esophageal varices reliable?

2019 ◽  
Vol 7 (2) ◽  
pp. 508
Author(s):  
Akshatha Savith ◽  
Sidhartha Naidu Bhumireddy
Keyword(s):  
Platelet Count ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Non Invasive ◽  
Vein Diameter ◽  
One Year

Background: One of the most serious complications of portal hypertension is the development of esophageal varices and variceal bleeding due to the rupture of varices. The purpose of the study was to assess the efficacy of various clinical and laboratory parameters in predicting the presence and severity of esophageal varices in cirrhotic patients.Methods: This is an observational cross-sectional study done in the department of medicine in Vydehi Institute of Medical Sciences, Bengaluru over a period of one year. Total of 76 patients above the age of 18years with the diagnosis of cirrhosis of any etiology were included. Multivariate Backward method was applied and Portal vein diameter, Platelet count, PT INR, FIB-4 score, APRI, AST/ALT ratio were included as predictors in the model.Results: No statistically significant correlation was found between platelet count, portal vein diameter, FIB 4 score, APRI, AST/ALT ratio and presence of esophageal varices.Conclusions: Present study showed that the non invasive markers such as platelet count, portal vein diameter, FIB 4 score, APRI and AST/ALT ratio are not reliable in predicting the presence of esophageal varices.

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 

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