Dr Jagdish Choudhary, Dr Kishan Gopal Barupal


INTRODUCTION - Cirrhosis is responsible for 1.1% of all deaths as estimated by WHO. Portal hypertension is
considered an advanced complication of cirrhosis. Upper gastrointestinal endoscopy is required to detect the gastroesophageal
varices. But the procedure is invasive, painful to the patient, and is not available in all centers. To reduce the number of unnecessary
endoscopies in patients with cirrhosis but without varices, several studies have evaluated possible non-invasive markers of esophageal varices in
patients with cirrhosis.
STUDY DESIGN – A cross-sectional observational study.
METHOD AND MATERIAL – The patients had conrmed or suspected cases of portal hypertension were selected for study according to
inclusion and exclusion criteria.
RESULT - All patient having large varices had portal vein diameter ≥13 mm. The all 21 patients with large varices had spleen size ≥14 cm. Out of
36 patients with small grade varices 30 (83.33%) had spleen size ≥14 cm. Out of 57 patients 49 (85.96%) who had varices, majority had platelet
count less than 1,50,000.
CONCLUSION - These non-invasive parameters can signicantly predict the presence of esophageal varices and can be used as surrogate
markers for the presence of varices where endoscopic facilities not available.


portal hypertension, spleen size, upper gastrointestinal endoscopy

Full Text:



Gratch D, Bacchi CE, Corey L, Delaroza C, Lesniewski RR, Kowdley K et al. Persistent Hepatitis C Virus Infection after Liver Transplantation: Clinical and Virological Features. Hepatology.1995; 22:1-9.

P. Dite, D. Labrecque, Michael Fried, A. Gangl, A.G. Khan, D. Bjorkman. World Gastroenterology Organization practice guidelines esophageal varices. June 2008:1-2.

Update on management of variceal bleeding. Scottish Medical Journal. 2005; 45(1): 5-10.

Harrison's Principles of Internal Medicine; 18th edition.Longo Fauci .kasper. hauser.jamson.loscalzo volume 1; chapter 41, GASTROINTESTINAL BLEEDING. Pages 320 to 323.

Ahmed M. Velimir A. Luketic. Post Graduate Medicine. February 2001; 109: 60-2.

Sarwar S, Khan AA, Alam A et al. Non endoscopic prediction of presence of esophageal varices in cirrhosis J Call Physicians Surg Pak 2005 ; 15 (9) : 528-31.

Dib N,KonateA,ObestiF,Cales P.Noninvasive diagnosis of portal hyper tension in Cirrhosis.Application to the primary prevention of varices.GastroenterolClin Diol;2005;29(10);975-87.

D’Amico G, Garci´a-Tsao G, Cale`s P, Escorsell A, Cestari R, Caletti G, Nevens F. Diagnosis of portal hypertension. How and when? In: deFranchis R, ed. Portal Hypertension III. Proceedings of the third Baveno international consensus workshop on definitions, methodology and therapeutic Strategies. Oxford: Blackwell Science; 2001:36-63.

A Hekmatnia et al, prediction and screening of esophageal varices in cirrhotic patients using Doppler US hemodynamic indices of portal system; gastroenterology insights 2011;3e4.

FilippoSchepisetal,Which patients with cirrhosis should undergoendoscopic screening for esophageal varices detection?; DOI:10.1053 /jhep.2001.21410.

BC Kaji,Yagnesh R Bhavsar,NitinPatel,AnupamGarg,HirenKevadiya,Zishan;A Study of Clinical Profile of 50 Patients with Portal Hypertension and to Evaluate Role of Noninvasive Predictor of Esophageal Varices;Indian Journal of Clinical Practice, Vol. 22, No. 9, February 2012;Page:454-457.

E Giannini, F Botta, P Borro, D Risso, P Romagnoli, AFasoli. Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of esophageal varices in patients with liver cirrhosis. Gut 2003; 52: 1200–05.

WW Baig, MV Nagaraja, M Varma, R Prabhu. Platelet count to spleen diameter ratio for the diagnosis of esophageal varices: Is it feasible? Can J Gastroenterol 2008; 22(10):825-828.

M L Gill,MAtiq,Sattar S, Khokhar.N. Non-Endoscopic Parameters For The Identification Of Esophageal Varices In Patients With Chronic Hepatitis. journal of Pakistan medical association 2004;vol 54;n 11;pp 575-577.

P Cales, H Desmorat, J P Caucanas, A R avaud,etal,incidence of large esophageal varices in patients with cirrhosis:application to prophylaxis of first varicealbleeding;Gut 1990, 31,1298-1302.

Dr.K.V.L. SudhaRani,Dr.B.Sudarsi,Dr.R.Siddeswari, Dr.S. Manohar;Correlation of Portal Vein Size with Esophageal Varices Severity in Patients with Cirrhosis of Liver with Portal Hypertension;International Journal of Scientific and Research Publications, Volume 5, Issue 1, January 2015 1ISSN 2250-3153.

Sudhindta D Lakshman Kumar et al JAPI Vol. 5 December 2003.

Pleština Color Doppler ultrasonography is reliable in assessing the risk of esophageal variceal bleeding in patients with liver cirrhosis Wiener klinischeWochenschrift October 2005, Volume 117, Issue 19-20, pp 711-717.

Prihatini J, Lesmana LA, Manan C, GaniRA.Detection of esophageal varices in livercirrhosis using non-invasive parameters. Acta Med Indones 2005; 37: 126-3.

Chalasani, N.; Imperiale, T.F.; Ismail, A.; Sood, G.; Carey, M.; Wilcox,C.M.; Madichetty, H.; Kwo, P.Y. and Boyer, T.D. (1999): Predictors oflarge esophageal varices in patients with cirrhosis. Am J Gastroenterol. 94:3285-91.

Thomopoulos KC, Labropoulou-KaratzaC,Mimidis KP, Katsakoulis EC, IconomouG,Nikolopoulou VN. Non-invasive predictors of the presence of large esophageal varices in patients with cirrhosis. Dig Liver Dis.2003; 35: 473-8.

Madhotra R, Mulcahv HE, Willner I, Reuben A. Prediction of esophageal varices in patients with cirrhosis. J ClinGastroenterolgy 2002; 34: 81-5.[30] Fagundes ED, Ferreira AR, Roquete ML, Penna FJ, Goulart EM, FigueiredoFilho PP, et al. Clinical and laboratory predictors of esophageal varices in children and adolescents with portal hypertension syndrome. J PediatrGastroenterolNutr. 2008; 46:178-83.


  • There are currently no refbacks.