Platelet count/spleen diameter ratio; is it valid marker for large esophageal varices in chronic liver disease

International Journal of Medical Science

© 2018 by SSRG - IJMS Journal

Volume 5 Issue 1

Year of Publication : 2018

Authors : Saif Alam, Debobrata Goswami and Bikash Narayan Choudhury

10.14445/23939117/IJMS-V5I1P101

How to Cite?

Saif Alam, Debobrata Goswami and Bikash Narayan Choudhury, "Platelet count/spleen diameter ratio; is it valid marker for large esophageal varices in chronic liver disease," SSRG International Journal of Medical Science, vol. 5,  no. 1, pp. 1-5, 2018. Crossref, https://doi.org/10.14445/23939117/IJMS-V5I1P101

Abstract:

 Portal hypertension is the most common and lethal complication of chronic liver disease. It is directly related to morbidity and mortality in chronic liver disease patients. Bleeding from ruptured gastro-esophageal varices is a major complication of portal hypertension and a frequent cause of death. Early diagnosis and prevention of gastro-esophageal variceal bleed by medical and endoscopic intervention is the main stay in the long term management of chronic liver disease patients. Upper GI endoscopy is a gold standard and will remain the gold standard for diagnosis of gastro-esophageal varies. Screening of every patient at the time of diagnosis of liver cirrhosis was the main consensus. However, subjecting all the patient to screening endoscopy may not be justified due to socio economic constraints. So, to reduce unnecessary endoscopy, its cost and burden, several studies have evaluated possible noninvasive markers of gastro-esophageal varies in cirrhosis, which should be less expensive, non-invasive, accurate and reproducible. Most of these studies used parameters such as splenomegaly, thrombocytopenia, Childs score, ascites, portal flow patterns, and platelet count-splenic size ratio to predict the esophageal varices. Out of all these the platelet count/spleen diameter ratio of 909 or less is the only parameter which is independently associated with the presence of large esophageal varices, and its negative predictive value is reproducible.

Keywords:

noninvasive marker, esophageal varices, chronic liver disease.

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