We established the prevalence of gallbladder varices (GBVs) as seen on duplex sonogram of children with portal hypertension. Fifty-five consecutive children with portal hypertension underwent duplex sonographic examination by an experienced sonologist who was blinded to clinical presentation. Forty children had extrahepatic portovenous obstruction (EHPVO), 12 had cirrhosis, and three had noncirrhotic portal hypertension. GBVs were seen on sonography in 10 of 40 children with EHPVO (25%), two of 12 children with cirrhosis (16.6%), and no children with noncirrhotic portal hypertension. Sonographic findings of GBVs were confirmed on duplex sonographic imaging. Among patients with EHPVO, GBVs did not correlate with size of esophageal varices, number of sessions of sclerotherapy, presence or absence of gastric varices, portal gastropathy, or splenorenal shunt placement. In cirrhotic patients, GBVs did not correlate with Child Pugh grade. Children with EHPVO have a higher incidence of developing GBVs. The clinical significance of GBVs is their propensity to bleed during biliary surgery; thus, the operating surgeon should be made aware of them.
Introduction: Esophageal varices are generally the most common clinical manifestation of portal hypertension in Patients of liver cirrhosis. Most common causes of death in liver cirrhosis are hemorrhage from esophageal varices. The present study has been carried out to identify clinical, biochemical and ultrasonographic parameters which might non-invasively predict the existence and the risk of variceal bleed. Material and Methods: The present prospective observational study was conducted in 2 years among 100 patients suffering from liver cirrhosis above 18 years of age. Detailed history, clinical examination, investigations to fulfill the inclusion and exclusion criteria of all patients was taken. Different non endoscopic parameters were taken Plateletcount, Coagulation profile, Ultrasonography whole abdomen, Child-Pugh-Torcotte (CPT) Score, AST to platelet ratio index (APRI) for the detection of esophageal varices and its grading in liver cirrhosis patients which was confirmed by endoscopy. Results: There was significant association of presence of esophageal varices in liver cirrhosis patients with presence of icterus, presence of ascites,presence of splenomegaly, grade of Child Pugh Score, AST to Platelet rationdex (APRI score) Prothrombin Time and International Normalized Ratio(PT/ INR), mean TB (mg/dl), mean spleen size. Conclusions: The result of present study concluded that some parameters are strongly associated with grades of varices and could be useful for early detection and subsequent management of varices.
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