Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Bleeding from esophageo-gastric varices is a serious complication related to portal hypertension. In patients with cirrhosis, liver and splenic stiffness measurements (LSM and SSM) are useful to predict high-risk varices, bleeding and decompensation. Data regarding the utility of SSM for predicting bleeding in patients with non-cirrhotic portal hypertension (NCPH) is scarce.
Methods: Consecutive patients with NCPH (n = 150, 129 extrahepatic portal vein obstruction; 21 non-cirrhotic portal fibrosis) with baseline available LSM, SSM and HVPG values were included. Half of the patients had recent variceal bleeding (RVB, within 3 months). We aimed to study the association of baseline SSM, LSM, HVPG and the presence of hypersplenism with respect to the history of RVB and the long-term follow-up changes in LSM and SSM values.
Results: Baseline demographic and lab characteristics were comparable in patients with NCPH with/without RVB. Mean SSM and SSM/LSM ratios were higher in patients with RVB as compared to patients without RVB [90 ± 7.5 vs. 70 ± 7.8 kPa(p < 0.0001) and 16.51 ± 2.97 vs. 13.49 ± 2.66(p < 0.001) respectively]. The SSM (OR,1.085(95%CI:1.029-1.144) and the presence of hypersplenism [OR,0.379(0.157-0.91) were associated with RVB in multivariate analysis. The SSM (cut-off 75 kPa) has a sensitivity of 92% and specificity of 90% for being associated with RVB(AUROC-0.975). There were no significant changes in SSM on follow-up both in bleeders and those without bleeding; however, SSM at 12 months (88.3 ± 7.3 vs. 68.4 ± 7.8 kPa) and 24 months (87.4 ± 7.2 vs. 68.7 ± 7.2 kPa) remained significantly higher in bleeders than those without bleeding (p < 0.001).
Conclusion: Recent esophageo-gastric variceal bleeding is associated with significantly higher SSM in patients with non-cirrhotic portal hypertension, with a best cut-off of 75kPa. The SSM values remain high in bleeders up to 24 months of follow-up.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10620-025-09356-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Utility of splenic transient elastography in assessing the presence of portal hypertension: A review.
World J Methodol
December 2025
Department of Clinical Sciences, Lund University, Malmo 22100, Sweden.
Portal hypertension (PH) is a major complication of chronic liver disease, often leading to serious clinical consequences such as variceal bleeding, ascites, and splenomegaly. The current gold standard for PH diagnosis, namely, hepatic venous pressure gradient measurement, is invasive and not widely available. Transient elastography has emerged as a non-invasive alternative for assessing liver stiffness (LS), and recent studies have highlighted the potential role of splenic stiffness (SS) in evaluating PH severity.
View Article and Find Full Text PDFCorrelation of Spleen Stiffness with Esophageo-gastric Variceal Bleeding in Patients with Non-cirrhotic Portal Hypertension.
Dig Dis Sci
September 2025
Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Background: Bleeding from esophageo-gastric varices is a serious complication related to portal hypertension. In patients with cirrhosis, liver and splenic stiffness measurements (LSM and SSM) are useful to predict high-risk varices, bleeding and decompensation. Data regarding the utility of SSM for predicting bleeding in patients with non-cirrhotic portal hypertension (NCPH) is scarce.
View Article and Find Full Text PDFManagement of acute variceal bleeding: updated APASL guidelines.
Hepatol Int
August 2025
Institute of Liver and Biliary Sciences, New Delhi, India.
Acute variceal bleeding (AVB) is a common life-threatening complication of portal hypertension (PHT), having a six-week mortality of 10%-20%. Major advances in the hemodynamic management, risk stratification, pharmacotherapy, endoscopy techniques, hemostatic devices and radiological interventions have led to improved management and outcome of AVB patients in the recent past. Therefore, the APASL Portal Hypertension Working Party, chose a panel of experts, primarily from the Asia-Pacific region, to identify important developments and controversial areas in the field of AVB.
View Article and Find Full Text PDFDiagnostic and Clinical Implications of High Spleen-To-Liver Stiffness Ratio in MASH-A Prospective, Comparative Study.
Liver Int
October 2025
Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Background: Liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) represent non-invasive surrogates of portal hypertension (PH) that both correlate with hepatic venous pressure gradient (HVPG). SSM may overcome limitations of HVPG and LSM in detecting presinusoidal PH components. We investigated the SSM/LSM ratio as a PH surrogate and its relationship to HVPG and spleen diameter across different liver disease aetiologies.
View Article and Find Full Text PDFA Case of Hepatic Decompensation Caused by IgG4-positive Plasma Cell Infiltration Mimicking Sclerosing Cholangitis, Who Achieved a Four-year Survival by Glucocorticoid Treatment.
Intern Med
August 2025
Department of Gastroenterology and Hepatology, Kansai Medical University, Japan.
A 51-year-old man was referred to our hospital because of a worsening liver function after a follow-up of13 years for elevated hepatobiliary enzyme levels of unknown etiology. The IgG4 (4,990 mg/dL) levels were markedly elevated. Imaging revealed splenomegaly, intrahepatic bile duct dilatation, and an early enhancement area in the right lobe.
View Article and Find Full Text PDF