Correlation between Portal Vein Diameter and Esophageal Varices Grades in Chronic Liver Disease Patients using Ultrasonography and Endoscopy as a Diagnostic Tool

Abstract

Background: Chronic liver disease accounts for 2.2% of deaths and 1.5% of disability-adjusted life years. Variceal bleeding is one of the preventable caused of death in chronic liver disease. About 30-40% of patients with compensated cirrhosis and 85% of those with decompensated cirrhosis are found to possess EV on screening endoscopy.
Objective: To determine the correlation between Portal Vein Diameter (PVD) on ultrasound examination and grades of Esophageal Varices (EV) on endoscopy in patients with Chronic liver disease (CLD).
Material and Methods: This was a cross-sectional, correlational study, carried out in the Department of Diagnostic Radiology in collaboration with the Department of Gastroenterology, at Lady Reading Hospital Peshawar, Pakistan. A total of sixty patients were sampled via consecutive random sampling from Jan 2022 to Sept 2022. The criteria used for dilated portal vein was = 13mm and = 13 cm for splenomegaly.
Results: Out of total 60 patients with CLD, PVD ranged from 10 to 18mm, mean PVD being 14.1mm ±1.4. The splenic sizes ranged from 10 to 23 cm, with the mean splenic cranio-caudal dimension being 14.9 cm ± 2.1. The highest association is between the large EV and PVD > 15 mm i.e., 52% of total large EVs. The differences between PVD to EV groups were statistically significant as determined by one-way ANOVA (F (2,57) =8.281, p= 0.001) and correlation was also statistically significant on Pearson's Correlation test (rs)[60] = 0.490, p < 0.001.
Conclusion: As there is a significant positive correlation between PVD and grades of EV in CLD patients. The PVD on ultrasound should be utilized where an endoscopic facility is not available, or is overburdened, to prevent life threatening esophageal variceal bleed.
Keywords: Chronic liver disease, Esophageal varices, Portal vein diameter.