Platelet Count to Spleen Diameter Ratio as a Noninvasive Marker of Oesophageal Varices in Hepatic Cirrhosis.

Corresponding Author:
Dr. Bimal K. Agrawal,
Office of the Principal,
MM Institute of Medical Sciences and
Research, Mullana-133207, Ambala,
Haryana, India.
E-mail: onlybimal@gmail.com

ABSTRACT

BACKGROUND

Cirrhosis, a chronic liver disease is an important health problem. The common aetiological factors are hepatitis B, hepatitis C, alcohol consumption and non-alcoholic fatty liver disease. Oesophageal varices are an important complication of hepatic cirrhosis, its prevalence in a cirrhotic being nearly 80%. Variceal haemorrhage can be fatal, and it has been recommended that every patient with cirrhosis should be screened for oesophageal varices at the time of presentation. This may not be feasible in resource crunch setting. There is a need for simpler methods which may help suspect or diagnose oesophageal varices. In this study platelet count to spleen diameter ratio, as has been suggestive in some studies, has been analysed to find out as to whether it can be used as a marker of presence of oesophageal varices.

METHODS

One hundred and fifty patients of cirrhosis of liver were included in this study. All patients underwent upper gastrointestinal endoscopy for the presence of oesophageal varices. Total platelet count (per cubic millimetre) to splenic diameter (in millimetre) ratio was calculated for each patient.

RESULTS

It was observed that there exists a correlation between the ratio of platelet count and bipolar spleen diameter for the prediction of oesophageal varices. A cut off value of P/S ratio of 909 correlated well with the presence of varices. The subject with advanced disease as per Child Pugh classification had lower P/S ratio.

CONCLUSIONS

Platelet count to spleen diameter ratio can be used as a sensitive marker for the prediction of oesophageal varices in patients with cirrhosis of liver.

KEY WORDS

Cirrhosis of Liver, Oesophageal Varices, Platelet Count, Spleen Diameter