Evaluation of Spleen Stiffness Compared to Splenic Artery Resistive Index as Non Invasive Predictors for Esophageal Varices in Patients with Chronic Liver Disease

Abstract

ortal hypertension is an abnormal elevation in the blood pressure within the portal circulation which is caused by a functional resistance to blood flow at any part of portal venous system and also increase in the blood flow of the portal venous system (De Franchis and Primiganim, 2001). With this in mind, in our study we used the Spleen stiffness measurement by TE and SARI. The aim of this work was to identify parameters which might non-invasively predict the presence of any OV in patients of chronic liver disease and in the same time to assess the predictiveness of these identified rules in patients with cirrhosis. 60 cases with chronic liver diseas were selected. Upper gastro-intestinal endoscopy was done for all cases for the presence of OV; accordingly the patients were then divided into three groups according to the presence/absence of any esophageal varices and its grading.We evaluated the biochemical parameters for all patients, including: total and direct bilirubin, ALT, AST, alkaline phosphatase, serum albumin, prothrombin time, INR, and CBC including platelet count.All patients were classified according to Child-Pugh's criteria. Also, an ultrasonography of the abdomen was done to measure the maximal spleen bipolar diameter, PV diameter, ascites and SARI. We also measured spleen stiffness using fibroscan for all patients.