RESUMEN
Chronic liver disease develops when the functional capacity of the liver is deranged, and it is not able to maintain normal physiological conditions. This study was carried to find out the association of portal vein size with gastro-oesophageal varices in diagnosed cases of cirrhosis of liver, so that this parameters can be used in predicting propensity to oesophageal varices non-invasively, and thus help in starting prophylactic therapy earlier to prevent bleeding and other complications of varices.METHODS100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were included for the study. Ultrasonography was done in all cases to find out the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was performed to see the presence of oesophageal varices of different grades. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient. p Value of <0.05 was considered for significant.RESULTSAmong 100 patients studied, 90% patients were found to have oesophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 oesophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of splenic diameter with grades of oesophageal varices, it was found that patients with splenic diameter >13 cm had higher grades of oesophageal varices i.e. 32 patients were grade 2 and 18 patients were grade 3, with p<0.001 and was found highly significant.CONCLUSIONSIn this study, we found that with increasing spleen size there are chances of formation of higher grades of oesophageal varices and both are also having positive association.
RESUMEN
Objective: To study the predictive power of noninvasive investigative parameters (clinical, biochemical, radiological) for detection of esophageal varices in patients with portal hypertension (PHT) as compared to invasive parameters (upper gastrointestinal endoscopy). Materials and methods: Fifty patients with PHT, between May 2008 to September 2010, were studied. Those who had decompensated liver diseases, HIV, hepatocellular carcinoma, metastasis in liver, parentral drug addiction, chronic febrile illness, H/O treatment taken for PHT in the form of surgery or endoscopic bending or sclerotherapy were excluded. Detailed clinical history was taken and physical examination was done. All patients underwent the required hematological, biochemical, radiological, endoscopic and histopathological investigations. Results: Platelet count/splenic size showed a significant correlation between presence or absence and grade of esophageal varices (p < 0.00015). If a cut-off value of 1,000/cu mm is taken, then 87.5% (35/40) patients with esophageal varices have ratio <1,000 while 20% (2/10) of patients with ratio <1,000 did not have any varices. It was also observed that lower the ratio, higher the grade of varices. Conclusion: Asymptomatic esophageal varices, which is quite common, can be easily diagnosed with invasive endoscopy or otherwise can be suspected with noninvasive predictors like platelet/spleen size ratio in our country, where financial constraint is a major problem for investigations like endoscopy.
RESUMEN
PURPOSE: The purpose of this study was to establish the guidelines for normal splenic length by sonographic measurement. MATERIALS AND METHODS: In 481 children (age range : 2-16years, M:F=1.5:1), abdominal sonography for the purpose of health screening was carried out, and the greatest length of spleen between the dome and tip was measured. Correlation and regression analysis was used to determine whether the relationship between splenic length and a patient's age, height, weight and body surface was statistically significant. RESULTS: The length of the spleen gradually increased according to age. Correlation and regression analysis showed significant positive correlation (p<0.0001) between splenic length and age (r=0.610) height (r=0.630), weight (r=0.598), and body surface (r=0.628). CONCLUSION: From the mean values of spleen length in children, an index useful for clinical application might be derived.