DOI: 10.36347/sjams.2019.v07i07.050

Pages: 2525-2530

Portal hypertension commonly accompanies the presence of chronic liver disease, and the development of oesophageal varices is one of the major complications of portal hypertension. Aims: To study the ultrasonographic parameters, platelet counts and platelet count and spleen diameter ratio in prediction of severity of oesophageal varices in chronic liver disease. Methods: This cross-sectional observational study was done in the department of General Medicine, Prathima Institute of Medical Sciences Hospital, Naganoor, Karimnagar. A total of n=50 portal hypertensive patients were studied during the study period and n=50 normal age and sex-matched individuals were taken as controls. Exclusion criteria were Cases of portal hypertension who are on  blockers, Cases of portal hypertension who underwent EST or EVL. Cases of portal hypertension who underwent TIPS or shunt surgery. Routine biochemical investigations, liver function tests were done in every patient. Every recruited patient underwent Ultrasonography and Fiberoptic upper gastrointestinal endoscopy. Platelet count spleen diameter ratio was calculated. Results: Relationship of cases and controls based on Child-Turcotte-Pugh Classification for Severity of Cirrhosis score was calculated for all the patients with most of the patients with varices fall in group C and without varices in group B. Platelet count shows the highest sensitivity for the detection of oesophageal varices with 82.69% followed by platelet count/splenic diameter of 80.77%. Specificity is highest for splenic diameter and platelet count/splenic diameter. Platelet count/splenic diameter show the highest sensitivity of 88% and specificity is highest for splenic diameter with 69.23% for detection of large varices. 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.