ABSTRACT
Objective: In this study our main objective is to evaluate therelationship between Oesophageal varices, Portal veindiameter and splenic length (antero-posterior).Methodology: This Cross-sectional comparative studyconducted at the Department of Hepatology, BangabandhuSheikh Mujib Medical University (BSMMU) from Jan 2010 toDec 2011 where 50 Patients with cirrhosis of liver attending thedepartment of Hepatology, BSMMU were included as apopulation in this study.All the data was checked and edited after collection. It wasexpressed as Mean and SD. Data has been analyzed byANOVA. p value of less than 0.05 was considered statisticallysignificant. Statistical analysis was done by using SPSS-15(Statistical package for social sciences) win version 15software programme.Results: During the study, the mean age was43.12±15.68years. The highest frequency of cirrhosis patientswas found in 41-50 years age groups (Frequency 12). Leadingcause was HBV (68%) followed by HCV (12%), NBNC (12%),Wilson’s disease (6%) and both HVB& HCV (2%). Also,grade-3 mean portal Vein diameter was found 12.67±2.47 mmwhereas; mean splenic length (antero-post.) was 13.82±2.12cm.Conclusion: Splenic antero-posterior measurement is not areliable predictor for sizes of oesophageal varices. Furtherstudy is needed for better outcome.
ABSTRACT
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.