scholarly journals Correlation between Endosonographic and Doppler Ultrasound Features of Portal Hypertension in Patients with Cirrhosis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
A. Wiechowska-Kozłowska ◽  
K. Zasada ◽  
M. Milkiewicz ◽  
P. Milkiewicz
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Doppler Ultrasound ◽  
Gastric Wall ◽  
Splenic Vein ◽  
Maximum Velocity ◽  
Invasive Procedure ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Cross Sectional

Purpose. Endoscopic ultrasound (EUS) permits the detailed visualization of clinically significant features of portal hypertension; however, it is an invasive procedure that is not widely available. The aim of this cross-sectional study was to determine whether a correlation exists between the features of portal hypertension detected using both Doppler ultrasound and EUS in subjects with liver cirrhosis.Materials and Methods. Analyzed cohort included 42 patients who underwent a detailed Doppler ultrasound focusing on the parameters of blood flow in the portal/splenic vein as well as an endoscopic/EUS procedure that included the assessment of the size and localization of “deep” varices.Results. The size of “deep” oesophageal varices detected with EUS exhibited no correlation with the parameters assessed by Doppler ultrasound. However, the size of the “deep” gastric varices detected using EUS correlated with the time averaged maximum velocity (Tmaxas well asVmin,Vmax) for the portal vein using Doppler ultrasound and exhibited a correlation with theVmaxandTmaxfor the splenic vein. No significant correlation was determined between the diameter of the azygous vein and the thickness of the gastric wall when seen on EUS versus the parameters measured with Doppler ultrasound.Conclusion. EUS provides important information regarding the features of portal hypertension, and in the case of “deep” oesophageal varices exhibits a limited correlation with the parameters detected by Doppler ultrasound. Thus, despite its invasiveness, EUS is a method that provides a reliable and unique assessment of the features of portal hypertension in patients with liver cirrhosis.

scholarly journals Ultrasonographic evaluation of portal hypertnsion

Mediscope ◽  
2015 ◽  
Vol 2 (1) ◽  
pp. 27-31
Author(s):  
MS Ahamed ◽  
PK Chowdhury ◽  
AS Mohiuddin ◽  
MA Hossain ◽  
B Paik
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Splenic Vein ◽  
Cross Sectional Study ◽  
Oesophageal Varices ◽  
Deep Inspiration ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Mesenteric Veins ◽  
Diameter Variation

A descriptive type of cross-sectional study was done to measure diameters of splenic, superior mesenteric and portal veins with their variation with respiration in patients with portal hypertension. Trans-abdominal ultrasonography was used for the purpose among purposively selected 59 patients with chronic liver disease and portal hypertension using computer sonography with multiple probes having multiple frequency depending on physical built of subjects. The diameters of selected veins were measured in the course of expiration and deep inspiration. Mean age of respondents was 53.2 years with standard deviation of 11.4 years. 44 (74.6%) subjects were male, whereas 15 (25.4%) were female. In all cases oesophageal varices were present. Portal vein was clearly visualized in all cases, while splenic vein in 53 (89.8%) cases and superior mesenteric vein in 49 (83.1%) cases. During deep inspiration, diameter of portal vein was greater than 13 mm in 31 (52.5%), while ?13 mm in 28 (47.5%) of portal hypertensive cases. Of 31, lack variation in diameter during respiration was observed in 29 (93.6%) cases. Size of liver (length in mid-clavicular line) in 18 (30.5%) cases were between 96 to 115 mm, while in 19 (32.2%) cases it was within 116 to 135 mm and in 22 (37.3%) cases it was between 136 to 160 mm. In 36 (61.0%) cases surface of liver was irregular, while in 51 (86.4%) cases parenchymal echotexture of liver was coarse. Size of spleen was enlarged in 44 (74.6%) cases, and ascites was present in 47 (79.7%) cases. Diameter variation with breathing of splenic and superior mesenteric veins observed only in 5 (8.5%) patients. Lack of diameter variation of portal, splenic and superior mesenteric veins with respiration in ultrasonography is an indicator of portal hypertension.Mediscope Vol. 2, No. 1: 2015, Pages 27-31

scholarly journals Peptic Ulcer Diseases in Patients with Liver Cirrhosis and Portal Hypertension: Experience in a Tertiary Level Hospital in Bangladesh

2021 ◽  
Vol 16 (2) ◽  
pp. 68-71
Author(s):  
Ahmed Lutful Moben ◽  
Md Abdullahel Kafee ◽  
Md Jahangir Kabir ◽  
Arunanagshu Raha ◽  
Farjana Majid ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Peptic Ulcer ◽  
Portal Hypertension ◽  
Peptic Ulcer Disease ◽  
Oesophageal Varices ◽  
Portal Hypertensive Gastropathy ◽  
Class Iii ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Cirrhosis Of Liver

Introduction: Cirrhosis of liver and peptic ulcer disease (PUD) are very common in Bangladesh. PUD may coexist with cirrhosis and portal hypertension. Haematemesis and melaena in cirrhosis of liver are not always from ruptured oesophageal varices; rather it may be due to bleeding peptic ulcer disease. Objective: To find the prevalence of PUD among patients with liver cirrhosis and portal hypertension. Materials and Methods: This cross sectional, descriptive study was conducted on 96 patients of cirrhosis of liver diagnosed with oesophageal varices at endoscopy unit of Kurmitola general hospital, during endoscopic evaluations in 4 months period from september 2017 to december 2017. Results: Total cirrhotic patients enrolled were 96 (M=61, F=35), mean age was 51.8 ± 14.2 yrs (18-86years). Hepatitis B virus (HBV) was the leading cause of cirrhosis in 54.1%, Hepatitis C virus (HCV) 5.2 %, proven non-alcoholic steatohepatitis (NASH) were 11.5% and rest were from unknown aetiology. Their average Child-Turcotte-Pugh (CTP) score were 8.6 (12-5), 37.6% associated with portal hypertensive gastropathy. Grade-III oesophageal varices found in 52 patients, whereas grade-II in 25 patients. Among this 96 patients 39 (40.6%) revealed peptic ulcer disease more in the form of gastric ulcer (n=23) than duodenal ulcer (n=10) and both (n=6). Most of the ulcers belonged to Forrest class III (76.9%). Conclusions: Variceal bleeding and portal hypertensive gastropathy are the common causes of bleeding and anaemia in patients with cirrhosis of liver. Peptic ulcer disease has been found to be one of the potential causes of haematemesis, melaena, and anaemia among these patients in Bangladesh. Large multicenter controlled studies are needed to confirm the reports. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 68-71

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 Noninvasive assessment of oesophageal varices presence and size in patients with liver cirrhosis using right liver lobe/serum albumin concentration

2007 ◽  
Vol 64 (7) ◽  
pp. 453-457
Author(s):  
Tamara Alempijevic ◽  
Vladislava Bulat ◽  
Nada Kovacevic ◽  
Rada Jesic ◽  
Srdjan Djuranovic ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Oesophageal Varices ◽  
Digestive Endoscopy ◽  
Liver Lobe ◽  
Albumin Ratio ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Upper Digestive Endoscopy ◽  
The Right

Background/Aim. Liver cirrhosis is a chronic, progressive disease and it is usually accompanied by portal hypertension. The development of oesophageal varices (OV) is one of the major complications of portal hypertension. Cirrhotic patients should be screened for the presence of OV when portal hypertension is diagnosed. In order to reduce the increasing burden that endoscopy units have to bear, some studies have attempted to identify parameters for noninvasive prediction of OV presence. The aim of our study was to evaluate the value of biochemical and ultrasonography parameters for prediction of OV presence. Methods. This study included 58 cirrhotic patients who underwent a complete biochemical workup, ultrasonography examination and upper digestive endoscopy. Right liver lobe diameter/albumin ratio was calculated and its correlation to the presence and degree of OV, and Child-Pugh score of liver cirrhosis explored. Results. The mean age of the patients included in the study was 53.07?13.09 years; 40 were males and 18 females. In the Child-Pugh class A were 53.4% patients, class B 39.7%, whereas 6.9% were in the class C. In 24.1% of the patients no OV were identified by upper digestive endoscopy, 19% had OV grade I, 34.5% grade II, 20.7% grade III, and 1.7% OV grade IV. The mean value of the right liver lobe diameter/ albumin ratio was 5.43?1.79 (range of 2.76?11.44). Statistically significant correlation (p < 0.01) was confirm by Spearman's test between OV grade and calculated index (? = 0.441). Conclusion. The right liver lobe diameter/albumin ratio is a noninvasive parameter which provides an accurate information pertinent to the determination of OV presence and their grading in patients with liver cirrhosis. .

scholarly journals Platelet Count/Splenic Diameter Ratio to Predict Oesophageal Varices in Portal Hypertension

2019 ◽  
Vol 2 (2) ◽  
pp. 192-196
Author(s):  
Buddhi Sagar Lamichhane ◽  
Manoj Koirala ◽  
Bishwo Raj Baral
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Rural Areas ◽  
Predictive Value ◽  
Tertiary Hospital ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Cirrhosis Of Liver

Background: One of the major causes of morbidity and mortality in Nepal is portal hypertension due to liver cirrhosis. In rural areas where a lot of cases of cirrhosis of liver are prevalent and endoscopic expertise and facilities are not available, predicting the presence of esophageal varices through non-invasive means may reduce a large number of unnecessary endoscopies. This study is to identify the relationship of platelet count /splenic bipolar diameter ratio with the presence of esophageal varices in portal hypertension. Materials and methods: Eighty patients were included in this study between Jestha 2072 to Baisakh 2073 with the diagnosis of portal hypertension admitted in Bir hospital, Kathmandu which is a tertiary hospital of government of Nepal, which were mostly due to liver cirrhosis. The patients fulfilling the inclusion criteria underwent lab investigations, ultra sonogram and UGI endoscopy. The data were assessed for descriptive studies and means were compared using t-test. The cut off value of platelet count to spleen diameter ratio of 1150 was used to predict the presence or absence of oesophageal varices. Statistical analysis was done using SPSS 20 software Results: Platelet count to splenic diameter ratio with a cut off value of 1150 has sensitivity of 89.7%, specificity of 83.3%, positive predictive value of 96.8% and negative predictive value of 58.8% (p= 0.002, CI=95%) with 89.5 % accuracy. Conclusion: Platelet count to splenic bipolar diameter ratio can be a good predictor of presence of esophageal varices in patients with portal hypertension in the resource poor settings.

scholarly journals THE RELATIONSHIP OF APRI SCORE (ASPARTATE AMINOTRANS FERASE-TO-PLATELET RATIO INDEX) AND PUGH CHILD SCORE

2020 ◽  
Vol 7 (2) ◽  
pp. 122-129
Author(s):  
Adelia Muhlifa Saputri ◽  
Magdaleni Agustina Rahayu ◽  
Sinta Murti
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Function ◽  
Esophageal Varices ◽  
Aspartate Aminotransferase ◽  
Secondary Source ◽  
Cross Sectional ◽  
Prognosis Of Liver Cirrhosis ◽  
Apri Score ◽  
Relationship Of

Liver cirrhosis is the last stage of chronic liver disease that is in the path of the disease can cause damage of liver function and/or portal hypertension. The prognosis of liver cirrhosis can be assessed by manifestations of liver function disorders with Child Pugh score that include the presence or absence of ascites, encephalopathy, bilirubin serum, albumin serum, and prothrombin time or INR, while portal hypertension also occurs in patient of cirrhosis can lead the formation of esophageal varices. APRI score has platelet count and AST serum as its variable is suspected to be related to the Child Pugh score in assessing prognosis of cirrhosis patients. This study purposed to find the relation between APRI score (Aspartate Aminotransferase-to-Platelet Ratio Index) and Child Pugh score. Purpose of this research is to find the relation between APRI score (Aspartate Aminotransferase-to-Platelet Ratio Index) and Child Pugh score and degree of esophageal varices in patients with cirrhosis. Method used is a retrospective analytic study with cross sectional approach. The data source is secondary source. The sample in this study were patients with liver cirrhosis who were diagnosed by a doctor and had complied the inclusion criteria. The data obtained was analyzed using ANOVA. The result of this study is include 48 cirrhosis patients, male 81,3%, with a mean age 49,98 years. The most common cause of cirrhosis is hepatitis B obtained from reactive HBsAg examination in 33 patients (68,8%). The APRI score was found to have a weak correlation (r = 0.044) and not significant (p = 0.868) with the Child Pugh score. The APRI score do not able to assess the prognosis in advanced cirrhotic patients.

scholarly journals DECOMPENSATED CIRRHOSIS

2015 ◽  
Vol 22 (11) ◽  
pp. 1397-1402
Author(s):  
Sarwat Iqbal ◽  
Muhammad Haroon Yousaf ◽  
Muhammad Ifitikhar Yousuf ◽  
Wasim Uddin
Keyword(s):  
Portal Hypertension ◽  
Gastric Varices ◽  
Cross Sectional Study ◽  
Decompensated Cirrhosis ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Upper Gi Endoscopy ◽  
Diagnostic Modalities ◽  
Poor Outcomes

Cirrhosis with subsequent portal hypertension is a major health problemworldwide. Among various etiologies, HCV is the leading cause of chronic hepatocellularinjury. Cirrhosis being the commonest cause of portal hypertension results in a spectrum ofcomplications. Approximately 5-15% of cirrhotic develop varices. Gastric varices althoughpresent less frequently as compared to esophageal varices but are associated with greatermortality and morbidity. Objectives: To determine prevalence of Gastric varices in patients withdecompensated cirrhosis. Study Design: Cross sectional study. Place & Duration: Carriedout at two centers, Pakistan Ordinance Factories Hospital Wah Cantt and Shalimar HospitalLahore from Jan 2014 to Jan 2015. Subjects: A total of 421subjects of decompensate cirrhosiswere included in the study. Methods: Patients with decompensate cirrhosis of any etiology whowere visiting the two hospitals as inpatient or outpatient were included in the study. Upper GIendoscopy was done in all these subjects for determination of gastric varices. Results: Among421 patients of decompensate cirrhosis, frequency of gastric varices was 10.9%, GOV1 as themost common variant. Gastric varices contributed to 5.4% of all variceal bleeds. Conclusion:Gastric varices are found in significant number of patients of decompensate cirrhosis. Sincegastric varices are associated with increased mortality and poor outcomes, these shouldbe carefully looked during upper GI endoscopy. Successful management of gastric varicealhemorrhage necessitates availability of expertise and newer diagnostic modalities.

scholarly journals Endoscopic therapy for gastro-oesophageal varices of Caroli’s syndrome: a case report

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051987799 ◽  
Author(s):  
Song Wang ◽  
Mei Xiao ◽  
Liqun Hua ◽  
Yong Jia ◽  
Si Chen ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Hepatic Fibrosis ◽  
Endoscopic Therapy ◽  
Tissue Adhesive ◽  
Injection Sclerotherapy ◽  
Oesophageal Varices ◽  
Endoscopic Injection Sclerotherapy ◽  
Endoscopic Injection ◽  
Caroli’S Syndrome

Caroli’s disease (CD) is a very rare congenital disorder that is characterized by non-obstructive, segmental and cystic dilatation of intrahepatic ducts. Most patients with CD are asymptomatic, but some patients may suffer from hepatic fibrosis, liver cirrhosis or/and portal hypertension. In complex CD, cystic dilatations of the intrahepatic bile ducts can be present with congenital hepatic fibrosis, liver cirrhosis, portal hypertension, oesophageal varices and autosomal recessive polycystic kidney disease; a condition known as Caroli’s syndrome. This report describes the case of a 28-year-old woman that had gastro-oesophageal varices that were caused by hepatic fibrosis and portal hypertension as part of Caroli’s syndrome. The patient underwent successful treatment with endoscopic injection sclerotherapy with lauromacrogol and endoscopic variceal obturation using tissue adhesive. There were no immediate complications and the patient remained free of complications at 1-year follow-up. There are no current reports in the published literature describing Caroli’s syndrome induced by gastro-oesophageal varices that were treated by a combination of endoscopic injection sclerotherapy and endoscopic variceal obturation. Endoscopic therapy was an effective technique for the treatment of gastro-oesophageal varices in a patient with Caroli’s syndrome awaiting a liver transplant.

scholarly journals External Hemorrhage from a Portacaval Anastomosis in a Patient with Liver Cirrhosis

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Murat Biyik ◽  
Ramazan Ucar ◽  
Sami Cifci ◽  
Orhan Ozbek ◽  
Gokhan Gungor ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Abdominal Wall ◽  
Variceal Bleeding ◽  
Anterior Abdominal Wall ◽  
Major Complication ◽  
Gastric Varices ◽  
Portacaval Anastomosis ◽  
Esophageal And Gastric Varices

Variceal bleeding is the major complication of portal hypertension in patients with liver cirrhosis. Hemorrhage mainly occurs in gastrointestinal lumen. Extraluminal hemorrhages are quite rare, such as intraperitoneal hemorrhages. We aimed to present a variceal bleeding case from the anastomosis on the anterior abdominal wall, as an extraordinary bleeding location, in a patient with portal hypertension in whom there were no esophageal and gastric varices.

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