Doppler surrogate endoscopy for screening esophageal varices in patients with cirrhosis.
BACKGROUND
Portal hypertension is a common consequence of hepatic cirrhosis, which causes esophageal varices. Bleeding from varices has a high mortality rate. The present gold standard for diagnosing varices is endoscopy. Considering endoscopy side effects and patients' low acceptance, there have been always efforts for finding alternative diagnostic methods including Doppler ultrasonography (US).


OBJECTIVE
The aim of the present study was to evaluate changes of Doppler indices in cirrhotic patients with and without esophageal varices.


METHODS
Sixty six patients with known cirrhosis entered this cross-sectional study. Gastroscopy was performed for patients, and the first questionnaire was filled based on the Japanese Portal Hypertension Society guidelines. Then patients were referred for Doppler US of splenoportal system, and information was documented in the second questionnaire.


RESULTS
Forty-four patients were male and 22 female. Forty six patients had esophageal varices, and 20 did not. There were no significant associations between splenoportal indices found by Doppler US, and presence of esophageal varices in patients. However, we found a negative association between platelet ratio to spleen diameter, and to splenic vein diameter.


CONCLUSIONS
Neither of studied variables was perfect to differentiate cirrhotic patients with and without EVs. Endoscopy is still the gold standard diagnostic method for diagnosing esophageal varices in patients with cirrhosis. It seems that some of the splenoportal Doppler indices are promising, but more research and evaluation is necessary.
Department of Internal Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Kambiz
K
Akhavan Rezayat
Division of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, IR Iran.
Fariborz
F
Mansour Ghanaei
Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
Ahmad
A
Alizadeh
Division of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, IR Iran.
Afshin
A
Shafaghi
Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
Ali
A
Babaei Jandaghi
Endoscopy; Esophageal and Gastric Varices; Ultrasonography, Doppler, Duplex