ArticleDigestive diseases and sciences2026
Correlation of Spleen Stiffness with Esophageo-gastric Variceal Bleeding in Patients with Non-cirrhotic Portal Hypertension.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBleeding from esophageo-gastric varices is a serious complication related to portal hypertension. In patients with cirrhosis, liver and splenic stiffness measurements (LSM and SSM) are useful to predict high-risk varices, bleeding and decompensation. Data regarding the utility of SSM for predicting bleeding in patients with non-cirrhotic portal hypertension (NCPH) is scarce.
methodsConsecutive patients with NCPH (n = 150, 129 extrahepatic portal vein obstruction; 21 non-cirrhotic portal fibrosis) with baseline available LSM, SSM and HVPG values were included. Half of the patients had recent variceal bleeding (RVB, within 3 months). We aimed to study the association of baseline SSM, LSM, HVPG and the presence of hypersplenism with respect to the history of RVB and the long-term follow-up changes in LSM and SSM values.
resultsBaseline demographic and lab characteristics were comparable in patients with NCPH with/without RVB. Mean SSM and SSM/LSM ratios were higher in patients with RVB as compared to patients without RVB [90 ± 7.5 vs. 70 ± 7.8 kPa(p < 0.0001) and 16.51 ± 2.97 vs. 13.49 ± 2.66(p < 0.001) respectively]. The SSM (OR,1.085(95%CI:1.029-1.144) and the presence of hypersplenism [OR,0.379(0.157-0.91) were associated with RVB in multivariate analysis. The SSM (cut-off 75 kPa) has a sensitivity of 92% and specificity of 90% for being associated with RVB(AUROC-0.975). There were no significant changes in SSM on follow-up both in bleeders and those without bleeding; however, SSM at 12 months (88.3 ± 7.3 vs. 68.4 ± 7.8 kPa) and 24 months (87.4 ± 7.2 vs. 68.7 ± 7.2 kPa) remained significantly higher in bleeders than those without bleeding (p < 0.001).
conclusionRecent esophageo-gastric variceal bleeding is associated with significantly higher SSM in patients with non-cirrhotic portal hypertension, with a best cut-off of 75kPa. The SSM values remain high in bleeders up to 24 months of follow-up.
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