Assessment of the presence and severity of esophagogastric varices by splenic index in patients with liver cirrhosis

Purpose: To determine whether spleen size is related to the severity of esophageal varices or associated gastric varices and liver functions in patients with cirrhosis. Method: The authors retrospectively studied spleen size on CT (splenic index [SI] = length x width x height of the spleen), liver functions, and the results of esophagogastric endoscopy in 110 patients with cirrhosis. They also analyzed SI in 112 controls. Results: In controls, body weight, height, and age affected the SI. The SI in patients with uncompensated cirrhosis was greater compared with the SI in those with well-compensated disease (p = 0.0363). The SI in patients with esophageal varices was greater than in patients without esophageal varices (p < 0.0001), but patients with and without gastric varices had similar SI values. The SI in patients with the red color signs (red wale marking. cherry red spot, and hematocystic spot) on esophageal varices or with risky varices (enlarged tortuous varices with heady, nodular, or tumor shape associated with red color signs) was greater than in patients without these signs (p = 0.0029 and p = 0.0030, respectively). Conclusion: The SI is a good indicator of the severity of esophageal varices and hepatic functional reserve in patients with cirrhosis.