Senthil Kumar, R (2012) Portal haemodynamics as a predictor of oesophageal varices in cirrhotic patients. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
INTRODUCTION : Portal hypertension is the most common and dreaded complication of chronic liver disease. It is responsible for the development of gastroesophageal varices, variceal hemorrhage, ascites, renal dysfunction, portosystemic encephalopathy, hypersplenism, and hepatopulmonary syndrome. Bleeding from ruptured oesophagogastric varices is a major complication of portal hypertension and a frequent cause of death. Only 40% of Child pugh class A patients have varices, while they are present in 85% of Child pugh class C patients. AIM : To evaluate the relationship of Doppler parameters of hepatic and portal vasculature, hepatic vein wave forms with presence and size of oesophageal varices in cirrhotic patients. MATERIALS AND METHODS : A cohort of cirrhotic patients identified by clinical, laboratory and radiological parameters were evaluated. They were investigated for oesophageal varices by oesophagoduodenoscopy and by Doppler ultrasound. The relation between the presence and size of oesophageal varices and Doppler parameters were studied. RESULTS : Fifty two patients were enrolled in this prospective study. There were 44 male and 8 female patients. 23 patients were in Child Pugh Class C , 16 in Child Pugh Class B and 13 in Child Pugh Class A.Small oesophageal varices were associated with monophasic wave forms in 19.4%. biphasic wave forms in 38.7%, triphasic wave forms in 41.9%. Large oesophageal varices were associated with monophasic wave forms in 42.1%. biphasic wave forms in 52.6%, triphasic wave forms in 6.3%. The p- value was statistically significant with 0.013 [p <0.05].Spleen size greater than 15.3 was associated with large oesophageal varices which was statistically significant. Except for splenic artery resistivity index, none of the other Doppler parameters were statistically significant for large oesophageal varices. CONCLUSION : Our study data suggested that monophasic hepatic vein wave forms, splenic artery resistivity index, and spleen size greater than 15. 3 cms were related with presence of large oesophageal varices.These parameters may help in targeted identification of patients with large oesophageal varices and aid in their management.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Cirrhosis ; Doppler ultrasound ; Hepatic vein wave forms ; Oesophageal varices. |
| Subjects: | MEDICAL > Gastroenterology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 14 Jul 2017 03:09 |
| Last Modified: | 14 Jul 2017 03:09 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1612 |
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