Rakesh Panjwani, Wish Lal Sunder, Pawan Kumar, Waqas Hussain, Vijay Kumar, Sundeep Kumar.
Portal vein diameter and spleen size as non-invasive predictors of esophageal varices in patients with viral cirrhosis.
Pak J Surg Jan ;36(1):20-4.

Objective: To determine the frequency of esophageal varices in patients with cirrhosis and to evaluate the diagnostic value of mean spleen size and portal vein diameter for non-invasive detection of esophageal varices. Material and Methhods: This cross-sectional study was conducted at Medical Unit-I, Dr. Ruth K. M. Pfau Civil Hospital, Karachi from July 2016 to January 2017. A total of 200-patients with established cirrhosis were included. The severity of cirrohosis was classifi ed according to Child-Pugh classification. Ultrasound was done to assess portal vein diameter and splenic measurements. Definitive diagnosis of esophageal varices was done on endoscopy. Data were entered and analyzed in SPSS version 21. Descriptive statistics and Chi-square test were applied. P-value <=0.05 was taken as significant. Results: There were 132 (66%) males and 68 (34%) females. Out of 200-patients,155 (77.5%) were found to have esophageal varices on endoscopy. Overall, mean spleen size was 14.93 +- 2.99 cm and mean portal vein diameter, 1.23 +- 0.25 cm. Signifi cant association of esophageal varices was observed with age (p<0.001), duration of cirrhosis (p=0.010), Child-Pugh class (p=0.039) and etiology of liver cirrhosis (p<0.001) while no significant association was observed with gender (p=0.411), BMI (p=0.300), residence (p=0.252), socio-economic status (p=0.262) and smoking (p=0.359). Statistically significant differences were found in mean spleen size (p<0.001) and portal vein diameter(p<0.001) among patients with or without esophageal varices. Conclusion: In conclusion, spleen size and portal vein diameter may be used as reliable non-invasive predictors for the presence of esophageal varices among cirrhotic patients in resource-constrained setting.

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