Significance of liver/spleen stiffness in patients with portal hypertension-related gastrointestinal lesions

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  • Takeshita Eiji
    Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine
  • Hirooka Masashi
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Tanaka Takaaki
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Hashimoto Yu
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Tange Kazuhiro
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Hanayama Masakazu
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Yagi Sen
    Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine
  • Yamamoto Yasunori
    Endoscopy center, Ehime University Hospital
  • Koizumi Yohei
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Watanabe Takao
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Yoshida Osamu
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Tokumoto Yoshio
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Abe Masanori
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
  • Ikeda Yoshio
    Endoscopy center, Ehime University Hospital
  • Hiasa Yoichi
    Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine

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Other Title
  • 門脈圧亢進症に関連する消化管病変における肝硬度・脾硬度の臨床的意義
  • モンミャクアツ コウシンショウ ニ カンレン スル ショウカカン ビョウヘン ニ オケル カン コウド ・ ヒコウド ノ リンショウテキ イギ

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Abstract

<p>Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) as well as esophagogastric varices (EV) are crucial complications, which may provoke gastrointestinal bleeding, in patients with portal hypertension. Recently, the liver stiffness measured using ultrasound was shown to be associated with the extent of portal hypertension. Moreover, we previously reported that the spleen stiffness also showed association with hepatic venous pressure gradient (HVPG), which may reflect the risk for EV bleeding. Thus, in the present study, the significance of liver/spleen stiffness on possible risk for bleeding from hypertension-related gastrointestinal lesions (PHRGLs), including PHG and GAVE as well as EV, was investigated. A total of 92 patients with chronic liver diseases were enrolled, and the relation between PHRGLs and clinical factors such as hepatocellular carcinoma, liver function and liver/spleen stiffness were evaluated. EV, PHG, and GAVE were seen in 41.3%, 43.5%, and 9.8% of patients, respectively. Liver stiffness (mean±SD) was greater in patients with PHRGLs (2.114±0.060) than in those without PHRGLs (1.802±0.046) (p＜0.005). Spleen stiffness was also greater in the former patients (2.621±0.102) than in the latter patients (2.263±0.041) (p＜0.05). Multivariate analysis identified the spleen stiffness, peripheral platelet counts and serum albumin levels as significant factors responsible for development of PHRGLs. In conclusion, although both liver stiffness and spleen stiffness showed association with PHRGLs development, the spleen stiffness was the most useful factor predicting the occurrence of PHRGLs.</p>

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