Effectiveness of ultrasound and colour doppler in prediction of oesophageal varices in chronic liver disease patients.

Dr. Nitin D. Wadhwani; Dr. Aneesh P. Amte; Dr. Ashwini V. Kudtarkar

Volume : VI, Issue : IV, April - 2016

Effectiveness of ultrasound and colour doppler in prediction of oesophageal varices in chronic liver disease patients.

Dr. Nitin D. Wadhwani, Dr. Aneesh P. Amte, Dr. Ashwini V. Kudtarkar

Abstract :

Purpose–It is recommended that all the cirrhotic / chronic liver disease patients should be screened for presence of OV (Oesophageal Varices) by endoscopy but it has many disadvantages such as it is expensive, adds to patient discomfort and bears a risk of complications (like oesophageal perforation, aspiration of gastric contents and bacteremia). Our study aimed to determine whether ultrasound and Colour Doppler indices can be used to predict the presence or absence of OV. Materials and methods– Fifty six patients with chronic liver disease attending our hospital from August 2011 to August 2013 were included in this cross sectional study. They underwent thorough clinical, biochemical and hematological examination. USG (Ultrasonography) and Colour Doppler parameters relevant in prediction of oesophageal varices were studied. Upper GIT(Gastrointestinal Tract) endoscopy was performed to confirm presence or absence of oesophageal varices. Significance and P values of quantitative and qualitative parameters were found using unpaired ‘t’ test and chi square test. Receiver Operating Characteristic curves (ROC curves) were drawn for significant variables. A scoring system was developed which could predict oesophageal varices. Results –– Statistically significant parameters in the prediction of OV were platelet count, WBC count, splenic length, splenic index, platelet count/splenic length, mean PV(portal vein) velocity, splenoportal index, SPV(splenic vein) and SMV(superior mesenteric vein) caliber and presence of collaterals. Based on these parameters we developed a scoring system which could predict OV. On statistical analysis of scoring system we found that 55.35% of diagnostic endoscopies can be avoided. Conclusion–– Some USG, Colour Doppler and biochemical parameters can be used as an alternative to more invasive and more expensive upper GIT endoscopy.