Use of non-invasive scales for detecting esophageal varices in paediatric patients with portal vein thrombosis

Introduction: Portal vein thrombosis (PVT) is the most frequent cause of portal hypertension in paediatric population. Baveno VI Consensus considers endoscopic variceal ligation as the second therapeutic option after meso -Rex bypass (surgical shunt). Aim: Analyse the diagnostic profitability of non-invasive scales in order to predict the risk of oesophageal varices (OV) in children with PVT. Material and methods: Descriptive retrospective study where every upper gastrointestinal endoscopy (UGE) carried on patients <15 years old with non-cirrhotic PVT were included. There were divided according to the presence of OV and sex, cause, age, previous gastrointestinal bleeding or treatments, results of UGE and scales (Clinical Prediction Rule -- CPR), Varices Prediction Rule -- VPR), King's Variceal Prediction Score -- K-VaPS) and Platelet count/Spleen diameter Ratio -- PSR). Qualitative variables were expressed as absolute frequency and percentage, and quantitative variables as median and interquartile range. U Mann - Whitneyf and Hanley - McNeil tests were used for comparisons. Results: Forty-five UGE were analysed. 80% ( n = 36) presented OV: median of 3 (2 - 3) and 33.3% ( n = 12) required endoscopic variceal ligation. Statistical differences were demonstrated between both groups: CPR (142.39 [132.22-166.53] vs. 122.75 [115.24-133.15]; p = 0.003), VPR (9.91 [9.36-11.75] vs. 5.6 [3.34-8.39]; p = 0.001), K-VaPS (117.86 [99.66-126.58] vs. 99.64 [94.8810.18]; p = 0.019), PSR (2384.62 [1902.22-3201.63] vs. 1252.5 [579.6-2144.42]; p = 0.05), with and area under the curve AUROC > 75%, without statistical differences between scales. C onclusions: In paediatric patients with non-cirrotic PVT non-invasive scales can be used as a tool to predict the presence of OV and raise the indication of UGE. (c) 2023 Elsevier Espa & nacute;a, S.L.U. All rights reserved.