Clinical, endoscopic and sonographic relationship in patients with liver cirrhosis
Keywords:
liver cirrosis, ultrasonography doppler, endoscopy gastrointestinal, clinical evolution, diagnosisAbstract
Introduction: cirrhosis is the most advanced phase of liver diseases with high morbidity and mortality. There are non-invasive methods for diagnosing portal hypertension, such as Doppler ultrasound, which is currently performed on a regular basis in the diagnosis of patients with liver cirrhosis. Objective: to describe the clinical, endoscopic and sonographic relationship in patients diagnosed with liver cirrhosis treated at the Provincial Hepatology Consultation of the "Arnaldo Milián Castro" Hospital. Method: a descriptive, transversal study was carried out. The population consisted of all patients diagnosed with liver cirrhosis treated in 2015 and 2016. A non-probabilistic sampling was performed, 77 patients were selected. Results: 53 patients belong to the age group between 40-59 years, male patients predominated, 39 (50.65%) had a pathological abdominal ultrasound, of the 77 endoscopies, pathological findings compatible with portal hypertension were found in 31 (40, 26%) and the sonographic findings were related to the longer diagnosis of the disease, regardless of the etiology. Conclusions: patients with liver cirrhosis were in the middle age of life and were more masculine, approximately half presented alterations in the Doppler of the splenoportal axis and endoscopic signs of portal hypertension, the sonographic findings were related to the greater time of diagnosis disease, regardless of the etiology and the complications related to portal hypertension were significantly associated with the ultrasonographic and endoscopic pathological findings.Downloads
References
1. Bernal V, Bosch J. Cirrosis hepática. En: Montoro Huguet MA, García Pagán JC. Gastroenterología y Hepatología. Problemas comunes en la práctica clínica [Internet]. 2da ed. Madrid: Asociación Española de Gastroenterología; 2012 [citado 18 May 2016]. p. 867-891. Disponible en: http://www.aegastro.es/publicaciones/publicaciones-aeg/problemas-comunes-en-la-practica-clinica/libro-de-gastroenterologia-y-hepatologia-problemas-comunes-en-la-practica-clinica-2a-edicion
2. Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet [Internet]. 2014 May [citado 15 Dic 2016];383(9930):1749-61. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24480518
3. Cárdenas A, Solà E, Graupera I, Ginès P. Cirrhosis and its complications. En: ACP Medicine. American College of Physicians. June 2013.
4. Young-Hee Y, Hsiao-ye Y. Surveillance report #93. Liver cirrhosis mortality in the United States, 1970–2009 [Internet]. 2012 [citado 10 Sep 2016]. Disponible en: https://pubs.niaaa.nih.gov/publications/Surveillance93/Cirr09.pdf
5. López Méndez YI. Castro Narro GE. Evaluación integral del paciente con cirrosis hepática. En: Valdovinos Díaz M A, Bosques Padilla F, de Ariño Suárez M. Hepatitis y enfermedad inflamatoria intestinal. Gastrotrilogía III [Internet]. México: Asociación Mexicana de Gastroenterología; 2014 [citado 10 Sep 2016]. Disponible en: http://gastro.org.mx/wp-content/uploads/2017/11/GASTROTRILOGIA-III.pdf
6. Cuba. Ministerio de Salud Pública. Dirección Nacional de Registros Médicos y Estadísticas de Salud. 2015 [Internet]. La Habana: Minsap; 2016 [citado 15 May 2016]. Disponible en: http://files.sld.cu/dne/files/2016/04/Anuario_2015_electronico-1.pdf
7. Gerstenmaier JF, Gibson RN. Ultrasound in chronic liver disease. Insights Imaging [Internet]. 2014 Aug [citado 15 Dic 2016];5(4):441-55. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141343/
8. Vinueza Hidalgo G P. Caracterización de los pacientes con cirrosis hepática hospitalizados en el Hospital Eugenio Espejo en el periodo del año 2008 al 2011[tesis].Quito: Pontificia Universidad Católica del Ecuador; 2013. Disponible en: http://repositorio.puce.edu.ec/bitstream/handle/22000/7298/11.27.001080.pdf?sequence=4
9. Roman S, Zepeda-Carrillo EA, Moreno-Luna LE, Panduro A. Alcoholism and liver disease in Mexico: genetic and environmental factors. World J Gastroenterol [Internet]. 2013 Nov [citado 15 Dic 2016];19(44):7972-82. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848144/
10. Rehm J, Samokhvalov AV, Shield KD. Global burden of alcoholic liver diseases. J Hepatol [Internet]. 2013 Jul [citado 15 Dic 2016];59(1):160-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23511777
11. Giraldo Montoya Á M, Barraza Amador M, Villa Velásquez H, Martínez J W, García Castro G. Caracterización epidemiológica de pacientes con cirrosis en una consulta de gastroenterología en Pereira, Colombia, 2009-2012. Rev Méd Risaralda [Internet]. 2014 [citado 4 Feb 2017];20(2):86-94. Disponible en: http://www.scielo.org.co/pdf/rmri/v20n2/v20n2a04.pdf
12. Bazante Riofrio SP, Revelo Esquibel AP. Utilidad de las escalas Meld y Child Pugh como factores pronósticos de supervivencia en pacientes con diagnóstico de cirrosis hepática atendidos en el servicio de gastroenterología del Hospital Carlos Andrade Marín durante el periodo enero 2011 a junio 2013 [tesis]. Quito: Pontificia Universidad Católica del Ecuador. Facultad de Medicina; 2016. Disponible en: http://repositorio.puce.edu.ec/bitstream/handle/22000/9441/UTILIDAD%20DE%20LAS%20ESCALAS%20MELD%20Y%20CHILD%20PUGH%20COMO%20FACTORES%20PRON%C3%93STICOS%20DE%20SUPERVIVENCIA.pdf?sequence=1&isAllowed=y
13. Zhang CX, Hu J, Hu KW, Zhang C, Wang L and Xu JM. Noninvasive analysis of portal pressure by contrast-enhanced sonography in patients with cirrhosis. J Ultrasound Med [Internet]. 2011 [citado 15 Dic 2016];30(2):205-11. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.7863/jum.2011.30.2.205
14. Berzigotti A, Piscaglia F, EFSUMB Education and professional Standars Comitte. Ultrasound in portal hypertension-part 2--and EFSUMB recommendations for the performance and reporting of ultrasound examinations in portal hypertension. Ultraschall Med [Internet]. 2012 Feb [citado 15 Dic 2016]; 33(1):8-32. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22322479
15. Berzigotti A, Zoli M, Bru Saumell C, Gilabert Sole R. Ultrasound in the non-invasive evaluation of fibrosis and portal hypertension. En: de Franchis R, editor. Portal hypertension V: Proceedings of the Fifth Baveno International Consensus Workshop [Internet]. Oxford: Wiley-Blackwelled; 2010 [citado 15 Dic 2016]. p. 28-36. Disponible en: https://onlinelibrary.wiley.com/doi/book/10.1002/9781444393989
16. Stefanescu H, Procopet B. Noninvasive assessment of portal hypertension in cirrhosis: liver stiffness and beyond. World J Gastroenterol [Internet]. 2014 Dec [citado 15 Dic 2016];20(45):16811-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258551/
17. Macías Rodríguez MA, Rendón Unceta P, Marín Serrano E. Ecografía doppler en la hipertensión portal. En: Cuenca Morón B, González M, Garre Sánchez MC, Gil Grande LA, Gómez Rodríguez RA, López Cano A, et al. Tratado de Ultrasonografía abdominal [Internet]. 1ra ed. Madrid: Editorial Díaz Santos; 2011 [citado 4 Jun 2016]. p. 341-370. Disponible en: https://acomesf.org/articulos/Tratado-de-ultrasonografia-abdominal-AEED.pdf
18. Hatzakis A, Wait S, Bruix J, Buti M, Carballo M, Cavaleri M, et al. The state of hepatitis B and C in Europe: report from the hepatitis B and C summit conference. J Viral Herat [Internet]. 2011 Sep [citado 15 Dic 2016];18(Suppl1):1-16. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2893.2011.01499.x
19. European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2015. J Hepatol [Internet]. 2015 July [citado 15 Dic 2016];63:199-236. Disponible en: https://www.journal-of-hepatology.eu/article/S0168-8278%2815%2900208-1/fulltext
20. Kim YD, Cheon GJ, Kim MY, Suk KT, Baik SK, Kim DJ. Changes in the clinical outcomes of variceal bleeding in cirrhotic patients: a 10-year experience in gangwon Province, South Korea. GutLiver [Internet]. 2012 Oct [citado 15 Dic 2016];6(4):476-81. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493729/
21. Iwakiri 21.Y, Shah V, Rockey DC. Vascular pathobiology in chronic liver disease and cirrhosis - current status and future directions. J Hepatol [Internet]. 2014 Oct [citado 15 Dic 2016];61(4):912-924. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346093/
22. Iwakiri Y. Pathophysiology of portal hypertension. Clin Liver Dis [Internet]. 2014 [citado 15 Dic 2016];18(2):281-91. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24679494
23. Uchida H, Sakamoto S, Kobayashi M, Shigeta T, Matsunami M, Sasaki K, et al. The degree of spleen stiffness measured on acoustic radiation force impulse elastography predicts the severity of portal hypertension in patients with biliary atresia after portoenterostomy. J Pediatr Surg [Internet]. 2015 Apr [citado 15 Dic 2016];50(4):559-64. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25840063
24. Stefanescu H, Radu C, Procopet B, Lupsor-Platon M, Habic A, Tantau M, et al. Non-invasive ménage à trois for the prediction of high-risk varices: stepwise algorithm using lok score, liver and spleen stiffness. Liver Int [Internet]. 2015 Feb [citado 15 Dic 2016];35(2):317-25. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25228102
25. Shin SU, Lee J-M, Yu MH, Yoon JH, Han JK, Choi B-I, et al. Prediction of esophageal varices in patients with cirrhosis: usefulness of three-dimensional MR elastography with echo-planar imaging technique. Radiology [Internet]. 2014 July [citado 15 Dic 2016];272(1):143-53. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263640/
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms:
- Authors will retain their copyright and assign to the journal the right of first publication of their work, which will simultaneously be subject to a Creative Commons License / Attribution-Noncommercial 4.0 International (CC BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
- Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional repository or publishing it in a monographic volume) as long as the initial publication in this journal is indicated.
- Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).
15 junio 2025
