Endoscopic Ultrasonography in Patients with Chronic Liver Disease: A Case Control Study

Abstract

Background :

The portal system and azygos vein are the main drainage systems during portal hypertension. This study aims to compare the diameter of these veins by endoscopic ultrasonography (EUS) inpatients with and without chronic liver disease (CLD).

Materials and Methods :

During one year, patients with CLD enrolled as the study group. Patients who underwent EUS for other reasons during the same period served as controls. In cases with CLD, we assessed the relationship between degrees of hepatic dysfunction (Child-Pugh class), history of variceal bleeding, presence of hyponatremia, thrombocytopenia, and endoscopic grading of varices with the sizes of the portal, splenic, and azygos veins on EUS.

Results :

During the study period, there were 63 patients (20 females and 43 males) with CLD and 85 control subjects (42 females and 43 males) enrolled. The mean ages of cases was 45.60 ± 14 years and controls was 48.5 ± 15 years. The most common cause of CLD was post-necrotic cirrhosis due to hepatitis B virus. Patients with CLD had significantly higher mean portal, splenic, and azygos vein diameters than the control group (p ‹ 0.001). With azygos, portal, and splenic vein diameters of 10, 11 and 9 mm, sensitivity for the diagnosis of portal hypertension was 66%, 71%, and 66%, while specificity was 94%, 99% and 99%, respectively. Splenic and portal vein dilation, and thrombocytopenia significantly correlated with variceal bleeding ( p ‹ 0.05).

Conchusion :

EUS allows for the collection of valuable quantitative data from the portal system, the diagnosis of portal hypertension, and follow up of patients with CLD.