Predicting portal hypertension and variceal bleeding using non-invasive measurements of metabolic variables

Eslam, Mohammed; Ampuero, Javier; Jover, M.; AbdelHalim, Hesham A.; Rincón, Diego; Shatat, Mohammed; Camacho, I; Kamal, Amal; Iacono, Oreste Lo; Nasr, Zainb; Grande, Lourdes; Bañares, Rafael; Khattab, Mahmoud A.; Romero–Gómez, Manuel

doi:10.1016/s1665-2681(19)31343-2

Cited by 36 publications

(25 citation statements)

References 25 publications

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“…Previous studies reported a consistent relation between the splenic size and the portal venous pressure. This could be due to increased splenic red pulp blood volume from blood congestion in cirrhotic patients [1][2][3][4]. Other studies added that the most common parameters associated with varices include low platelet count, high prothrombin time, and increase in the Child-Pugh score.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies added that the most common parameters associated with varices include low platelet count, high prothrombin time, and increase in the Child-Pugh score. Thrombocytopenia reported in up to 64% of patients with portal hypertension is mainly caused by splenic sequestration as a complication of portal hypertensioninduced splenomegaly [3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, precise and early diagnosis of the esophageal varices is important. Non-invasive methods are needed to identify the esophageal varices in patients with chronic liver diseases [1][2][3][4]. Clinical examination is unreliable method for diagnosis of varices.…”

mentioning

confidence: 99%

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Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen

et al. 2015

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“…The platelet count in cirrhotics has been correlated with the degree of portal hypertension [39]. Therefore, the levels of platelets may vary considerably in patients with varying stages of cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Immature platelet fraction values predict recovery of platelet counts following liver transplantation

Mao

Lou

et al. 2015

Clinics and Research in Hepatology and Gastroenterology

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“…A HOMA score > 4 has a good ability to predict the presence of varices (100). A positive correlation is present between HOMA-IR and HVPG (100).…”

Section: Laboratory Testsmentioning

confidence: 99%

Invasive and non-invasive techniques for detecting portal hypertension and predicting variceal bleeding in cirrhosis: A review

et al. 2013

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Portal hypertension is a severe syndrome that may derive from pre-sinusoidal, sinusoidal and post-sinusoidal causes. As a consequence, several complications (i.e., ascites, oesophageal varices) may develop. In sinusoidal portal hypertension, hepatic venous pressure gradient (HVPG) is a reliable method for defining the grade of portal pressure, establishing the effectiveness of the treatment and predicting the occurrence of complications; however, some questions exist regarding its ability to discriminate bleeding from nonbleeding varices in cirrhotic patients. Other imaging techniques (transient elastography, endoscopy, endosonography and duplex Doppler sonography) for assessing causes and complications of portal hypertensive syndrome are available and may be valuable for the management of these patients. In this review, we evaluate invasive and non-invasive techniques currently employed to obtain a clinical prediction of deadly complications, such as variceal bleeding in patients affected by sinusoidal portal hypertension, in order to create a diagnostic algorithm to manage them. Again, HVPG appears to be the reference standard to evaluate portal hypertension and monitor the response to treatment, but its ability to predict several complications and support management decisions might be further improved through the diagnostic combination with other imaging techniques.

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Predicting portal hypertension and variceal bleeding using non-invasive measurements of metabolic variables

Cited by 36 publications

References 25 publications

Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen

Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen

Immature platelet fraction values predict recovery of platelet counts following liver transplantation

Invasive and non-invasive techniques for detecting portal hypertension and predicting variceal bleeding in cirrhosis: A review

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