Splenomegaly--an insensitive sign of portal hypertension
| Autor: | M. R. Ditchfield, Peter R. Gibson, J. D. Donlan, Robert N Gibson |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis Population Spleen Physical examination Chronic liver disease Gastroenterology Liver disease Internal medicine Hypertension Portal Internal Medicine medicine Humans education Duodenoscopy Liver Diseases Alcoholic Aged Ultrasonography Aged 80 and over education.field_of_study medicine.diagnostic_test business.industry Middle Aged medicine.disease Endoscopy medicine.anatomical_structure Splenomegaly Portal hypertension Female Radiology business |
| Zdroj: | Australian and New Zealand journal of medicine. 20(6) |
| ISSN: | 0004-8291 |
| Popis: | The prevalence of splenomegaly associated with portal hypertension was examined in a consecutive population of 111 patients who had portal hypertension diagnosed using specific endoscopic, sonographic, and Doppler signs. Splenic size was measured objectively via its cranio-caudal length on coronal section using ultrasound and by clinical examination. Sonographically, 52% of patients had a definitely large spleen and 35% a spleen less than one standard deviation from the normal mean, while a further 13% had equivocal splenomegaly. Only 52% of patients had splenomegaly on clinical assessment. Splenomegaly was less common in patients with alcoholic (41% definite, 15% equivocal) than in those with non-alcoholic liver disease (66% definite, 17% equivocal, p = 0.02) and splenic length was significantly smaller in alcoholic patients (12.7 +/- 0.5 cm) compared to patients with either non-alcoholic liver disease (15.0 +/- 0.6 cm, p = 0.003) or portal hypertension due to vascular occlusive diseases (16.5 +/- 2.0 cm, p = 0.006). Splenomegaly, whether assessed sonographically or clinically, is an insensitive sign of portal hypertension and its absence cannot be used as a negative predictor of the presence of portal hypertension in patients with chronic liver disease. |
| Databáze: | OpenAIRE |
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