Portal Vein Diameter by Ultrasonography as a non-Invasive Predictor of Esophageal Varices.

Abstract

Esophageal varices are one of the most serious consequence of portal hypertension in patients with liver diseases If undetected or left untreated, it can result in massive upper gastrointestinal bleed and can be fatal. Therefore, a timely detection and management of the varices in cirrhotic patient is a must. Several studies have evaluated possible noninvasive markers of esophageal varices to reduce the number of unnecessary endoscopies in patients with cirrhosis but without varices. Endoscopic surveillance of esophageal varices in patients with liver cirrhosis is expensive for the health system and uncomfortable for the patients. Recently, non-invasive ultrasound-based parameters seem to offer valuable information about the status of esophageal varices and thus challenge the need for repetitive endoscopic monitoring. In this study, our aim was to develop a predictive model using an independent risk factor for the presence of varices in the enrolled patients. This is a cross-sectional study. The study analyzed 50 patients with liver diseases from February 2014 to January 2015. All the patients with cirrhosis of either gender except those with hepatocellular carcinoma and previous surgical or medical intervention for portal hypertension were enrolled in the study. Ultrasound of the abdomen was done in all cases to note the portal vein diameter. The varices visualized were graded endoscopically. Data entry was done in SPSS version 20 and statistical analysis was done with Chi Square test. Total 50 patients were enrolled in the test. Varices was present in 47 (96%) of the patients. Small varices were present in 13 (26%) and large varices was present in 34 (68%) of patients. For the patients with small varices, the mean portal vein diameter was 13.23 mm and for those with large varices, the mean portal vein diameter was 16.83 mm. The above results signify that the presence of varices was associated with the mean portal vein diameter of 13.23 mm or more and the result was statistically significant with the p value of 0.024 Measurement of portal vein diameter by ultrasonography can be used as a non-invasive predictive indicator of the development of gastro- esophageal varices in patients with portal hypertension.