The Correlation between Portal Vein Diameter, Splenic Size, platelet count/spleen length ratio, and Gastro-Esophageal Varices in the Liver Cirrhosis

Abstract

Aims and objective: The main aim of this study was to employ non-invasive methodologies, such as evaluating the portal vein diameter (PVD) and the size of the spleen, as well as the ratio of platelet count to splenic length, in order to identify individuals with cirrhosis who are at a heightened risk of developing esophageal varices. Materials and Methods: The present study utilized a descriptive analysis methodology to investigate a cohort of 50 individuals who received a diagnosis of liver cirrhosis. The individuals, ranging in age from 35 to 70 years, were subjected to both ultrasonography and upper gastrointestinal endoscopy. The statistical analysis was performed utilizing the one-way analysis of variance (ANOVA) and chi-square tests within the Stata 14 software. Results: In the sample of 50 patients, it was shown that 23 individuals (46%) demonstrated a PVD greater than 12mm. Additionally, a statistically significant correlation was observed between an increase in PVD and a rise in variceal grading. Additionally, it was noted that a total of 31 individuals, including 62% of the sample, displayed a splenic size above 13 cm. Nevertheless, no statistically significant positive connection was observed between the increase in splenic size and the grading of varices. The positive predictive value of a platelet count/spleen length ratio less than 909 is 100%. Conclusion: The application of ultrasound-guided measurement of PVD exceeding 12.0 mm and splenic size exceeding 13.0 cm can be considered a dependable and independent approach for predicting the presence of varices in persons with a diagnosis of cirrhosis. The reliability of predicting esophageal varices is higher when using the platelet count/spleen length ratio of less than 909, as opposed to relying solely on spleen size. However, in cases where there has been no previous instance of gastrointestinal bleeding, it is recommended to consider the use of surveillance endoscopy if any of these predictors are identified in individuals with cirrhosis.

Keywords

• cirrhosis
• esophageal varices
• portal vein
• endoscopy
• ultrasonography