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Spleen Enlargement Linked to Cirrhotic Complications

It independently predicts variceal formation and growth, and first clinical decompensation

WEDNESDAY, Oct. 1 (HealthDay News) -- Because cirrhotic patients with enlarged spleens are at higher risk of developing portal hypertension complications, non-invasive measurement of spleen diameter may allow for prognostic stratification, according to a report published in the October issue of Clinical Gastroenterology and Hepatology.

Annalisa Berzigotti, M.D., of the Universita di Bologna in Italy, and colleagues studied 127 patients with cirrhosis who were evaluated clinically, endoscopically, and with periodic abdominal ultrasound for at least one year and followed them for a mean of 53 months.

After one year, the researchers found that 46.4 percent of the patients had a spleen enlargement of at least 1 centimeter. After five years, they found that patients with spleen enlargement were more likely to develop esophageal varices (84.6 percent versus 16.6 percent). They also found that patients with baseline compensated cirrhosis who had spleen enlargement were more likely to develop a first clinical decompensation (51.1 percent versus 19.5 percent).

"When we tested spleen enlargement in a multivariate analysis including the most frequently recognized prognostic indicators, it showed an independent predictive value both for variceal formation and growth, and for first clinical decompensation in compensated patients," the authors write. "In this setting, spleen enlargement determined a fourfold increase in the risk of first clinical decompensation."

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