The ratio of platelet count / spleen diameter is an easy, accurate and affordable way to detect esophageal varices caused by chronic liver diseases

Abstract

Variceal bleeding is one of the most serious consequences of liver cirrhosis due to its attendant high mortality. The prevalence of varices in patients with cirrhosis is approximately 60- 80% and the risk of hemorrhage is 25-35%. The incidence of first variceal hemorrhage ranges from 20 to 40% within 2 years. Recurrent bleedings occur in 30% to 40% of patients within the next 2 to 3 days and in up to 60 % within 1 week. Therefore, the prevention of esophageal varietal (OV) bleeding remains one of important long-term management lines of cirrhotic patients. The objective of the study is to assess the reliability of platelet count/spleen diameter (PC/SD) ratio for the noninvasive detection of OV in cirrhotic patients. One hundred twenty-five patients with history of chronic liver disease (CLD) were recruited from the GIT Hospital in The Medical City in Baghdad, Iraq. These patients had blood tests for platelet count, ultrasound examination to measure spleen diameter, and gastrostomy. Platelet count/spleen diameter ratio was calculated and compared with the presence/absence of oesophagealvarices. There was a high statistically significant correlation with high diagnostic accuracy of PC/SD ratio in detection esophageal varices and it was correlated well with size of varices. The platelet count/ bipolar spleen diameter ratio is a highly accurate noninvasive test to assess the OV in patients with CLD. It is easy to calculate and can lower the financial and sanitary burdens of endoscopy units, especially in developing countries.