Background: Portal hypertension is a complication of cirrhosis, which causes esophageal varices [EV], splenomegaly, ascites and hepatic encephalopathy. The gold standard for diagnosis of portal hypertension is hepatic venous pressure gradient [HVPG] measurement, which is not routinely performed in every hospital. There is evidence that the spleen stiffness value correlates with the HVPG.

Objective: To study the relationship between spleen stiffness and parameters of indicated portal hypertension and study the relationship between spleen stiffness and the presence of EV.

Materials and Methods: Thirty-eight patients with clinical signs or any indicators of cirrhotic portal hypertension were evaluated by measuring splenic diameter and portal vein diameter by ultrasound. The authors measured liver and spleen stiffness using transient elastrography and upper endoscopy for the diagnosis of EV.

Results: Spleen stiffness showed no significant correlation between groups indicated portal hypertension. Sixteen patients, in a group which had the highest median value of spleen stiffness, had EV (75%). The present study found 81.5% of all patients had EV; EV group tend to have higher median spleen stiffness values than those without EV, although this is not statistically significant (54.2 vs. 49.6 kPa, p = 0.38). Integrating liver stiffness value, splenic diameter and platelet count in terms of LSPS score, showed that LSPS score was significantly higher in the EV group (6.89 vs. 1.72, p = 0.011).

Conclusion: LSPS score, but not spleen stiffness was a good non-invasive measurement for predicting portal hypertension in terms of the presence of esophageal varices.

Keywords: Esophageal varices, Portal hypertension, Spleen stiffness