Relationship between the distribution of gastroesophageal varices and portal and splenic vein size

This work was done on 200 patients with gastric and oesophageal varices to study the relation between the distribution of varices [seen by upper endoscopy] and the portal and splenic vein size [determined by abdominal ultrasonography]. It was found that patients with pure oesophgeal varices had greater portal vein size than those with pure gastric varices. The difference was statistically highly significant [P < 0.001]. It was also found that patients with isolated gastric varices had greater splenic vein size than those with pure oesophageal varices. The difference was also highly significant [P < 0.001]./ Consequently, portal / splenic vein ratio [Pv / Sv ratio] was found to be larger in patients with oesophageal varices than those patients with isolated gastric varices [P < 0.001]. We found that Pv / Sv ratio has a very high specificity [94%] in diagnosing isolated gastric varices [whether alone or accompained by oesophageal varices but disconnected at the cardia] when it is

Sonographic findings that could explain resistant ascites in patients with liver cirrhosis

75 patients with liver cirrhosis and ascites classified into 2 groups. Group I included 50 patients with resistant ascites and group II included 25 patients with responding acsites were the subject of this work. The liver was significantly smaller in group I. Creatinine clearance and serum Na were significantly lower in group I. Serum alkaline phosphatase and alpha fetoprotein were significantly higher in group I. Portal vein thrombosis was diagnosed in 4 patients of group I [8%] compared with one patient of group II [4%]. HCC was detected in 6 patients of group I [12%] and in none of group II patients. Ascitic fluid was positive for acid fast bacilli in one patient of group I. Culture was positive in 4 patients of group I, E. coli in 3 and Staph. aureus in one, compared with none of group II. The study stressed the importance of ultrasonography in detection of the cause of resistance of ascites and in the evaluation and regular follow-up of patients with liver cirrhosis