Volume : 8, Issue : 3, March - 2019

CORRELATION OF PLATELET COUNT/SPLEEN DIAMETER RATIO AND UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS IN CHRONIC LIVER DISEASE PATIENTS

Dr. Arindam Banerjee, Kumkum Sarkar, Dr. D Gonjhu, Dr. N. Pramanik, Prof. A. K. Bhadra, Dr. K. D. Biswas

Abstract :

Background: Chronic liver disease (CLD) with its different aetilogy and presentation is a very common cause of hospital admission in a tropical country. Sometimes CLD presented with acute variceal bleeding which may be life threatening. Aim and Objective: To study the corelation between platelet count/spleen diameter ratio and detection of oesophageal varix(OV) by upper gastrointestinal endoscopy in patients with chronic liver disease. Methods: In our single centre, prospective, observational study, 70 consecutive patients with CLD were included. Results: In the present study, the most common symptom was abdominal distension (100%). Thrombocytopenia was present in 44(63%) of study population. There was a significant association between thrombocytopenia and OV. Majority of patients (75%) in the study population had spleen diameter (SD) between125-160mm and 25(47%) of them had OV. There was also no significant association between splenomegaly and OV, between the 2 groups with spleen diameter <160 mm and spleen diameter >160 mm. The majority (53%) of the study population had PC/SD ratio less than 1000. There was a significant association between PC/SD and OV, between the 2 groups - PC/SD <1000 and PC/SD >1000. Using a PC/SD ratio cut-off 909 the sensitivity was 97.14% and specificity was 100%. Conclusion : From our study it can be concluded that Platelet count/spleen diameter ratio is a strong parameter, which is independently associated with the presence of oesophageal varix in patients of chronic liver disease (CLD) irrespective of its aetiology and by using this non-invasive methods we can restrict the use of endoscopy to those cirrhotic patients who have high risk of OV.