Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study
Introduction: Upper Gastrointestinal Endoscopy is considered the best screening tool for varices among patients with chronic liver disease. However, it is an expensive and invasive procedure that is not routinely available in rural India. Abdominal ultrasonography along with colour Doppler study...
| Glavni autori: | , , , , , , |
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| Format: | Članak |
| Jezik: | English |
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JCDR Research and Publications Private Limited
2024-01-01
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| Serija: | Journal of Clinical and Diagnostic Research |
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| Online pristup: | https://www.jcdr.net/articles/PDF/18943/63278_CE[Ra1]_F[SK]_QC(KK_VI_IS)_PF1(VD_DK_OM)_PFA(VD_KM)_PN(KM).pdf |
| _version_ | 1827380132360224768 |
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| author | Soumya Sarathi Mondal Bikash Chandra Seth Sanjay Kumar Mandal Souvik Sarkar Enamul Hossain Souvik Kumar Das Rahul Kumar |
| author_facet | Soumya Sarathi Mondal Bikash Chandra Seth Sanjay Kumar Mandal Souvik Sarkar Enamul Hossain Souvik Kumar Das Rahul Kumar |
| author_sort | Soumya Sarathi Mondal |
| collection | DOAJ |
| description | Introduction: Upper Gastrointestinal Endoscopy is considered
the best screening tool for varices among patients with
chronic liver disease. However, it is an expensive and
invasive procedure that is not routinely available in rural India.
Abdominal ultrasonography along with colour Doppler study is
an inexpensive test commonly ordered for patients with chronic
liver disease. Recent literature suggests that ultrasonographic
parameters can be used to predict varices.
Aim: To determine if ultrasonography of the entire abdomen and
spleno-portal Doppler study findings can predict oesophageal
varices in patients with chronic liver disease.
Materials and Methods: The present hospital-based
observational, cross-sectional study was conducted in the
indoor ward of the Department of General Medicine at Medical
College and Hospital, Kolkata, India, over a duration of one year
from February 2021 to February 2022.
Total 100 patients with chronic liver disease, admitted to the
hospital ward, were included in the study. Child-Turcotte-Pugh
(CTP) scores were obtained for all patients. Ultrasonographic
and spleno-portal Doppler indices, such as liver size, spleen
size, portal vein diameter, splenic vein diameter, peak systolic
velocity of the portal vein, and portal vein/splenic vein
diameter ratio, were measured alongside upper gastrointestinal
endoscopy to detect varices. The data were analysed using
Statistical Package for Social Sciences (SPSS) version 28.0.
The Chi-square test was used to test for significant differences
in proportions (categorical data), and the independent t-test and
Analysis of Variance (ANOVA) with Tukey’s Post-hoc test were
employed to test for significant differences in means (continuous
data). Additionally, Receiver Operating Characteristic (ROC)
curves were obtained for statistically significant parameters to
predict the presence of varices.
Results: The study enrolled 100 patients (63% males, 37%
females) with a mean age of 49.19±14.965 years, ranging from
14 to 91 years. (median age of 52, range 14-91 years). Of these,
68 patients (68%) had oesophageal varices, while 32 (32%) did
not. The study found that a mean spleen size of 13.55 cm, a
mean portal vein diameter of 12.5 mm, and a mean splenic vein
diameter of ≥9.05 mm were predictive of varices. Additionally,
a mean portal vein/splenic vein diameter ratio of 1.6150 was
also predictive of varices. However, there was no significant
difference in mean liver size and peak systolic velocity between
those with and without varices.
Conclusion: The present study suggests that a spleen size, portal
vein diameter, splenic vein diameter, and portal vein/splenic
vein diameter ratio can be reliably used to predict oesophageal
varices among patients with chronic liver disease. |
| first_indexed | 2024-03-08T13:28:11Z |
| format | Article |
| id | doaj.art-1e438f2f699d44a197d3028a5f723dc5 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-08T13:28:11Z |
| publishDate | 2024-01-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1e438f2f699d44a197d3028a5f723dc52024-01-17T11:57:58ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2024-01-011701394710.7860/JCDR/2024/63278.18943Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional StudySoumya Sarathi Mondal0Bikash Chandra Seth1Sanjay Kumar Mandal2Souvik Sarkar3Enamul Hossain4Souvik Kumar Das5Rahul Kumar6Professor, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Associate Professor, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Professor, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Junior Resident, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Junior Resident, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Junior Resident, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Junior Resident, Department of General Medicine, Medical College and Hospital, Kolkata, West Bengal, India.Introduction: Upper Gastrointestinal Endoscopy is considered the best screening tool for varices among patients with chronic liver disease. However, it is an expensive and invasive procedure that is not routinely available in rural India. Abdominal ultrasonography along with colour Doppler study is an inexpensive test commonly ordered for patients with chronic liver disease. Recent literature suggests that ultrasonographic parameters can be used to predict varices. Aim: To determine if ultrasonography of the entire abdomen and spleno-portal Doppler study findings can predict oesophageal varices in patients with chronic liver disease. Materials and Methods: The present hospital-based observational, cross-sectional study was conducted in the indoor ward of the Department of General Medicine at Medical College and Hospital, Kolkata, India, over a duration of one year from February 2021 to February 2022. Total 100 patients with chronic liver disease, admitted to the hospital ward, were included in the study. Child-Turcotte-Pugh (CTP) scores were obtained for all patients. Ultrasonographic and spleno-portal Doppler indices, such as liver size, spleen size, portal vein diameter, splenic vein diameter, peak systolic velocity of the portal vein, and portal vein/splenic vein diameter ratio, were measured alongside upper gastrointestinal endoscopy to detect varices. The data were analysed using Statistical Package for Social Sciences (SPSS) version 28.0. The Chi-square test was used to test for significant differences in proportions (categorical data), and the independent t-test and Analysis of Variance (ANOVA) with Tukey’s Post-hoc test were employed to test for significant differences in means (continuous data). Additionally, Receiver Operating Characteristic (ROC) curves were obtained for statistically significant parameters to predict the presence of varices. Results: The study enrolled 100 patients (63% males, 37% females) with a mean age of 49.19±14.965 years, ranging from 14 to 91 years. (median age of 52, range 14-91 years). Of these, 68 patients (68%) had oesophageal varices, while 32 (32%) did not. The study found that a mean spleen size of 13.55 cm, a mean portal vein diameter of 12.5 mm, and a mean splenic vein diameter of ≥9.05 mm were predictive of varices. Additionally, a mean portal vein/splenic vein diameter ratio of 1.6150 was also predictive of varices. However, there was no significant difference in mean liver size and peak systolic velocity between those with and without varices. Conclusion: The present study suggests that a spleen size, portal vein diameter, splenic vein diameter, and portal vein/splenic vein diameter ratio can be reliably used to predict oesophageal varices among patients with chronic liver disease.https://www.jcdr.net/articles/PDF/18943/63278_CE[Ra1]_F[SK]_QC(KK_VI_IS)_PF1(VD_DK_OM)_PFA(VD_KM)_PN(KM).pdfchild-turcotte-pugh scoreendoscopypeak systolic velocityportal vein diametersplenic vein diameter |
| spellingShingle | Soumya Sarathi Mondal Bikash Chandra Seth Sanjay Kumar Mandal Souvik Sarkar Enamul Hossain Souvik Kumar Das Rahul Kumar Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study Journal of Clinical and Diagnostic Research child-turcotte-pugh score endoscopy peak systolic velocity portal vein diameter splenic vein diameter |
| title | Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study |
| title_full | Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study |
| title_fullStr | Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study |
| title_full_unstemmed | Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study |
| title_short | Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study |
| title_sort | abdominal ultrasonography and splenoportal doppler study for predicting oesophageal varices in patients admitted with chronic liver disease at a tertiary medical hospital in kolkata india a cross sectional study |
| topic | child-turcotte-pugh score endoscopy peak systolic velocity portal vein diameter splenic vein diameter |
| url | https://www.jcdr.net/articles/PDF/18943/63278_CE[Ra1]_F[SK]_QC(KK_VI_IS)_PF1(VD_DK_OM)_PFA(VD_KM)_PN(KM).pdf |
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