Introduction Haemmorhage from ruptured oesophageal varices is a major complication of portal hypertension due to liver cirrhosis, and is associated with a high mortality rate. Variceal bleeding accounts for 10%–30% of all cases of upper gastrointestinal bleeding. Early diagnosis of varices and prevention and treatment of bleeding improves survival.
International normalised ratio (INR) score >1.5, portal vein diameter of >13 mm, and thrombocytopenia have been found to be predictive of the likelihood of varices being present in cirrhotics. Patients with cirrhosis often undergo ultrasonography, however, following our observation that the portal vein diameter (PVD) was rarely reported, we performed an audit of our practice on the reporting of PVD in cirrhotics.
Method A single centre, retrospective analysis of abdominal/liver ultrasound reports for all decompensated liver cirrhosis patients admitted between December 2015 – February 2016 and April – June 2016 to a large district general hospital in North London.
Results 53 patients were included within the study.
Conclusion This study demonstrates that in cirrhotics, measurement of PVD, despite being a predictor of presence of varices, is not being reported in 89.58% of ultrasound scans. This may delay the diagnosis and management of varices. We recommend interventions to enhance the reporting of PVD to include:
1) doctors ordering ultrasound scan on cirrhotics to specifically request PVD as standard within the request form
2) ultrasonographers to specifically mention PVD as standard within their reports in cirrhotics.
Disclosure of Interest None Declared
- portal vein diameter
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