European Journal of Cardiovascular Medicine

Background: Cirrhosis is the end-stage of every chronic liver disease, resulting in the formation of fibrous tissue, disorganization of liver architecture, and nodule formation, which interferes with liver function and results in portal hypertension. Esophagogastroduodenoscopy is considered the primary modality for the detection and surveillance of EV and to determine the risk of bleeding, guidelines for adult cirrhotic patients recommend universal EV screening by esophagogastroduodenoscopy at the time of the diagnosis of cirrhosis. Material And Methods: It is an observational analytical study. The study comprised of 100 portal hypertensive patients who were admitted in Department of General Medicine, Raja Rajeshwari Medical College and Hospital over a period of 6 months. Spleen size was measured by placing the patient in supine position, using 2-5 MHz curvilinear transducer in the coronal plane of section, posteriorly in one of the lower left intercostals spaces. The patient was examined in various degrees of inspiration to maximize the window to the spleen. The spleen parenchyma is extremely homogenous and it has uniform mid to low echogenicity. When the spleen enlarges it can be more echogenic. A maximum cephalocaudal measurement exceeding 13 cm indicates enlargement with high degree of reliability. Results: Alcoholic liver disease is the most common etiology in this study corresponding to 62 % of cases followed by hepatitis B with 10%. Child pugh score was calculated for all the patients with most of the patients with varices fall in group C and without varices in group B. On univariate analysis portal vein diameter , spleen diameter, platelet count and platelet count and spleen diameter ratio was found to be significantly associated with the presence of varices .On multivariate analysis the presence of esophageal varices was significantly associated with platelet count < 102,000/ μl (OR 6.65; 95% CI,2.51-17.6), spleen diameter > 154 mm (OR 5.78; 95% CI, 2.4-13.94) , portal vein diameter > 13 mm (OR 2.49;95% CI, 1.1-5.62) and platelet count /spleen diameter <815 (OR 10.92 ;95% CI 4.07-29.26). Conclusion: Ultrasonography of abdomen is a simple, convenient and non-invasive method for assessing the severity of portal hypertension in patients and to predict the severity of esophagogastric varices indirectly.