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Category: Volume 09 Issue 09 September 2021
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Title: Usefulness of Splenic Stiffness Measurement for Predicting Esophageal Varices in Chronic Liver Disease

Authors: Sowmya R, Daisy Joseph.V, Deepa.S

 DOI: https://dx.doi.org/10.18535/jmscr/v9i9.06

Abstract

Background: Chronic parenchymal liver disease and their complications are major source of morbitity and mortality. One of such complication is bleeding from esophageal varices due to portal hypertension. Other major complications are ascites hepatic encephalopathy. But major cause of death in chronic liver disease is bleeding from esophageal varices.Early diagnosis of clinically significant portal hypertension (>10mmHg) and varices is of greater.

Patients are asymptomatic in early stages. Most of the patients will be diagnosed with varices only at later stages during routine screening or during bleeding manifestations. Hence its detection at a later stage will have higher mortality rate. But varices are effectively treatable before results in bleeding, hence it is important to diagnose accurately at an early stage3 and hence the appropriate treatment can be undertaken to reduce both morbidity and mortality.

Current methods of screening for esophageal varices is upper gastrointestinal endoscopy which is an invasive. Hence a noninvasive technique is needed to prevent unnecessary interventions and costly procedures in low-risk patients and lead to an appropriate start of primary prophylaxis in high-risk patients.

Materials and Method: Designed as diagnostic test evaluation among patients with chronic parenchymal liver disease who came for follow up in Department of Radiodiagnosis. One ninety five patients evaluated and findings were correlated prospectively with their upper gastrointestinal endoscopy results.

Results: Optimal cut off value for differentiating between No varices vs positive varices is 9.15 kpa with 95% CI and that of no varices, grade 1 varices vs grade 2, grade 3 varices is 11.3 kpa, No varices, grade 1 varices, grade 2 vs grade3 varices is 12.3kpa all with 95% CI(p=0.00)

Conclusion:  Spleen Ultrasound shear wave elastography can be used as a predictor for the presence of esophageal varices.

Ultrasound shear wave elastography of spleen helps in predicting the grades of esophageal varices

Keywords: Esophageal varices, Gastrointestinal endoscopy, Shear wave elastography, Splenic stiffness

References

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Corresponding Author

Daisy Joseph.V

Associate Professor, Department of Radiodiagnosis, Al Azhar Medical College, Thodupuzha, India