Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver
Introduction: Upper Gastro Intestinal (UGI) bleed is major cause of mortality and admissions in cirrhotics. Timely initiation of prophylaxis reduces the burden of disease. Few endoscopists at periphery are compelled to look at other options to identify at risk patients. This study explores Porta...
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doaj-de2dfa2516ba4e28a2e3ed0fdec58c452021-06-17T05:06:05ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-05-01155OC08OC1010.7860/JCDR/2021/47108.14879Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of LiverMS Revathy0Ajay Kandpal1B Sumathi2S Chitra3M Manimaran4G Sathya5Professor and Head, Department of Gastroenterology, Stanley Medical College, Chennai, Tamil Nadu, India.Senior Resident, Department of Gastroenterology, Stanley Medical College, Chennai, Tamil Nadu, India.Associate Professor, Department of Gastroenterology, Stanley Medical College, Chennai, Tamil Nadu, India.Assistant Professor, Department of Gastroenterology, Stanley Medical College, Chennai, Tamil Nadu, India.Assistant Professor, Department of Gastroenterology, Stanley Medical College, Chennai, Tamil Nadu, India.Assistant Professor, Department of Gastroenterology, Stanley Medical College, Chennai, Tamil Nadu, India.Introduction: Upper Gastro Intestinal (UGI) bleed is major cause of mortality and admissions in cirrhotics. Timely initiation of prophylaxis reduces the burden of disease. Few endoscopists at periphery are compelled to look at other options to identify at risk patients. This study explores Portal Vein Diameter (PVD) as an option while taking clues and corrections from past studies. Aim: To identify any association between increases in portal pressure with appearance of oesophageal varices. Materials and Methods: This was an observational crosssectional study on 75 patients of cirrhosis of liver, from November 2018 to June 2019. Baseline characteristics were noted and assessment of the severity of disease was done. Endoscopy and Portal Vein (PV) Doppler was performed in same time frame. ANOVA and unpaired t-tests were used for analysis of the collected data. A p-value <0.05 was considered significant in both the tests. Results: Grade of varices was found to have a direct relationship with portal diameter and a statistically significant inverse relationship with Portal Venous flow Velocity (PVV) (p-value 0.037). Total 28 patients had active bleed or history of UGI bleed and showed higher mean portal diameter and lower average portal velocity compared to patients without any history of variceal bleeding. A statistically significant relation was found between diameter of Portal Vein (PV) and ChildTurcotte-Pugh (CTP) grade from A to C. Patients with grade C had on an average, the biggest portal diameter and lowest PVV. Patients with Model for End-Stage Liver Disease (MELD) scores values higher than 14 and had higher mean PV diameter and a lower mean PVV. Also, hepato-fugal flow was recorded with advanced cirrhosis. Conclusion: In advanced cirrhosis, the PV Doppler can be thought of as a substitute to endoscopy in starting primary medical prophylaxis, though more extensive study needed to arrive at a definitive conclusion.https://www.jcdr.net/articles/PDF/14879/47108_CE_[RA]_F[IK]_PF1(AKA_SL)_PN(KM).pdfgastroesophageal varicesportal vein diameterportal vein flow velocity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
MS Revathy Ajay Kandpal B Sumathi S Chitra M Manimaran G Sathya |
spellingShingle |
MS Revathy Ajay Kandpal B Sumathi S Chitra M Manimaran G Sathya Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver Journal of Clinical and Diagnostic Research gastroesophageal varices portal vein diameter portal vein flow velocity |
author_facet |
MS Revathy Ajay Kandpal B Sumathi S Chitra M Manimaran G Sathya |
author_sort |
MS Revathy |
title |
Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver |
title_short |
Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver |
title_full |
Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver |
title_fullStr |
Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver |
title_full_unstemmed |
Association of Portal Vein Indices with Upper Gastrointestinal Endoscopic Findings in Patients with Cirrhosis of Liver |
title_sort |
association of portal vein indices with upper gastrointestinal endoscopic findings in patients with cirrhosis of liver |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2021-05-01 |
description |
Introduction: Upper Gastro Intestinal (UGI) bleed is major cause
of mortality and admissions in cirrhotics. Timely initiation of
prophylaxis reduces the burden of disease. Few endoscopists
at periphery are compelled to look at other options to identify
at risk patients. This study explores Portal Vein Diameter (PVD)
as an option while taking clues and corrections from past
studies.
Aim: To identify any association between increases in portal
pressure with appearance of oesophageal varices.
Materials and Methods: This was an observational crosssectional study on 75 patients of cirrhosis of liver, from
November 2018 to June 2019. Baseline characteristics were
noted and assessment of the severity of disease was done.
Endoscopy and Portal Vein (PV) Doppler was performed in
same time frame. ANOVA and unpaired t-tests were used for
analysis of the collected data. A p-value <0.05 was considered
significant in both the tests.
Results: Grade of varices was found to have a direct
relationship with portal diameter and a statistically significant
inverse relationship with Portal Venous flow Velocity (PVV)
(p-value 0.037). Total 28 patients had active bleed or history
of UGI bleed and showed higher mean portal diameter and
lower average portal velocity compared to patients without any
history of variceal bleeding. A statistically significant relation
was found between diameter of Portal Vein (PV) and ChildTurcotte-Pugh (CTP) grade from A to C. Patients with grade C
had on an average, the biggest portal diameter and lowest PVV.
Patients with Model for End-Stage Liver Disease (MELD) scores
values higher than 14 and had higher mean PV diameter and
a lower mean PVV. Also, hepato-fugal flow was recorded with
advanced cirrhosis.
Conclusion: In advanced cirrhosis, the PV Doppler can be
thought of as a substitute to endoscopy in starting primary
medical prophylaxis, though more extensive study needed to
arrive at a definitive conclusion. |
topic |
gastroesophageal varices portal vein diameter portal vein flow velocity |
url |
https://www.jcdr.net/articles/PDF/14879/47108_CE_[RA]_F[IK]_PF1(AKA_SL)_PN(KM).pdf |
work_keys_str_mv |
AT msrevathy associationofportalveinindiceswithuppergastrointestinalendoscopicfindingsinpatientswithcirrhosisofliver AT ajaykandpal associationofportalveinindiceswithuppergastrointestinalendoscopicfindingsinpatientswithcirrhosisofliver AT bsumathi associationofportalveinindiceswithuppergastrointestinalendoscopicfindingsinpatientswithcirrhosisofliver AT schitra associationofportalveinindiceswithuppergastrointestinalendoscopicfindingsinpatientswithcirrhosisofliver AT mmanimaran associationofportalveinindiceswithuppergastrointestinalendoscopicfindingsinpatientswithcirrhosisofliver AT gsathya associationofportalveinindiceswithuppergastrointestinalendoscopicfindingsinpatientswithcirrhosisofliver |
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1721374353777491968 |