Ultrasonographic Predictors of Esophageal Varices
| Autor: | Roberto Massao Yamada, Gabriel Hessel, C.P. Servidoni, Roberta V. de Alcantara, Maria de Fátima, Silvia Regina Cardoso |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Liver Cirrhosis medicine.medical_specialty Adolescent Portal hypertensive gastropathy Esophageal and Gastric Varices Chronic liver disease Severity of Illness Index Gastroenterology Veins Young Adult symbols.namesake Esophageal varices Internal medicine Prevalence medicine Humans Vascular Diseases Child Fisher's exact test Ultrasonography Portal Vein business.industry Gallbladder Stomach Infant Odds ratio Gastric varices medicine.disease medicine.anatomical_structure Liver ROC Curve Area Under Curve Child Preschool Multivariate Analysis Pediatrics Perinatology and Child Health symbols Varices business Digestive System Omentum Splenorenal Shunt Surgical |
| Zdroj: | Journal of Pediatric Gastroenterology & Nutrition. 57:700-703 |
| ISSN: | 0277-2116 |
| DOI: | 10.1097/mpg.0b013e3182a7bc2e |
| Popis: | Objective The aim of this study was to identify ultrasonographic predictors of esophageal varices (EVs) in children and adolescents with chronic liver disease (CLD) and extrahepatic portal venous obstruction (EHPVO). Methods This study evaluates 53 patients younger than 20 years with CLD or EHPVO and no history of bleeding or prophylactic EVs treatment. They were divided into 2 groups: group I (35 with CLD) and group II (18 with EHPVO). Splenorenal shunt (SS), gallbladder wall varices, gallbladder wall thickening (GT), and lesser omental thickness (LOT) were compared with the presence of EVs, gastric varices, and portal hypertensive gastropathy (PHG). Univariate (χ² test, Fisher exact test, and Wilcoxon signed rank test) and multivariate (logistic regression) analyses were performed. The area under the receiver operating curve was calculated. Results EVs were observed in 48.5% of patients with CLD and in 83.3% of patients with EHPVO. SS (P = 0.0329) and LOT (P = 0.0151) predicted EV among patients with CLD. A median of 5.3 mm of LOT was considered a predictor of EVs among these patients. Multivariate analysis showed SS as an independent predictor of EVs in patients with EHPVO (odds ratio 15). Gallbladder varices (P = 0.0245) and GT (P = 0.0289) predicted EVs among patients with EHPVO. PHG occurred more often among patients with CLD who had SS (P = 0.0384) and greater LOT (P = 0.0226). Conclusions SS and a greater LOT were indicative of EV among children and adolescents with CLD. Gallbladder varices and GT were indicative of EVs among patients with EHPVO. SS and a greater LOT were indicative of PHG among patients with CLD. |
| Databáze: | OpenAIRE |
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