Splenomegaly—an insensitive sign of portal hypertension
- 1 December 1990
- journal article
- Published by Wiley in Australian and New Zealand Journal of Medicine
- Vol. 20 (6), 771-774
- https://doi.org/10.1111/j.1445-5994.1990.tb00421.x
Abstract
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.Keywords
This publication has 7 references indexed in Scilit:
- Identification of a patent paraumbilical vein by using Doppler sonography: importance in the diagnosis of portal hypertensionAmerican Journal of Roentgenology, 1989
- A method of measuring quantitative hepatic function and hemodynamics in cirrhosis: The changes following distal splenorenal shuntSurgery Today, 1986
- Portal vein measurements by real-time sonographyAmerican Journal of Roentgenology, 1982
- Spleen Size and Portal Hypertension in CirrhosisDigestion, 1978
- Transection of the oesophagus for bleeding oesophageal varicesBritish Journal of Surgery, 1973
- Measurement of portal pressure and its clinical applicationAmerican Journal Of Medicine, 1970