Spleen Enlargement on Follow-Up Evaluation: A Noninvasive Predictor of Complications of Portal Hypertension in Cirrhosis

Berzigotti, Annalisa; Zappoli, P.; Magalotti, Donatella; Tiani, Carolina; Rossi, Valentina A.; Zoli, Marco

doi:10.1016/j.cgh.2008.05.004

Cited by 56 publications

(42 citation statements)

References 20 publications

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“…Histologically, chronic portal hypertension-induced splenomegaly features expanded white pulp and marginal zone areas and appears different to congestive splenomegaly, which is characterized by more prominent red pulp and less distinct white pulp regions [19, 20]. Clinically, splenomegaly has been associated with a poor prognosis in liver cirrhosis and utilized during radioactive or acoustic examinations as an index for the non-invasive assessment of esophageal varices and bleeding risks [1, 21, 22]. Splenic stiffness can also increase as splenomegaly advances [23].…”

Section: Splenic Abnormalities In Liver Cirrhosismentioning

confidence: 99%

The spleen in liver cirrhosis: revisiting an old enemy with novel targets

et al. 2017

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The spleen is a secondary lymphoid organ which can influence the progression of multiple diseases, notably liver cirrhosis. In chronic liver diseases, splenomegaly and hypersplenism can manifest following the development of portal hypertension. These splenic abnormalities correlate with and have been postulated to facilitate the progression of liver fibrosis to cirrhosis, although precise mechanisms remain poorly understood. In this review, we summarize the literature to highlight the mechanistic contributions of splenomegaly and hypersplenism to the development of liver cirrhosis, focusing on three key aspects: hepatic fibrogenesis, hepatic immune microenvironment dysregulation and liver regeneration. We conclude with a discussion of the possible therapeutic strategies for modulating splenic abnormalities, including the novel potential usage of nanomedicine in non-surgically targetting splenic disorders for the treatment of liver cirrhosis.

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Section: Splenic Abnormalities In Liver Cirrhosismentioning

confidence: 99%

The spleen in liver cirrhosis: revisiting an old enemy with novel targets

et al. 2017

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“…Very enlarged spleens may also be at risk of spontaneous rupture or rupture after minor trauma [1]. In addition, in patients with cirrhosis, the observation of enlargement of the spleen during the follow-up is associated with increased probability of complications of portal hypertension [3]. To date, there is no specific medical therapy for splenomegaly.…”

Section: Introductionmentioning

confidence: 98%

Relevance of the mTOR signaling pathway in the pathophysiology of splenomegaly in rats with chronic portal hypertension

Mejías¹,

García-Pras²,

Gallego³

et al. 2010

Journal of Hepatology

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“…Porto-systemic collaterals such as left gastric vein > 3 mm and short gastic veins (collaterals at upper spleen half) strongly suggest the presence of esophageal varices [58], and their development/increase in number have been associated with a greater proportion of variceal formation and growth [59]. Similarly, progressive spleen enlargement may predict variceal formation and growth [60].…”

Section: Ultrasound and Colour-doppler-ultrasoundmentioning

confidence: 99%

“…As for the prediction of first clinical decompensation of any kind, spleen enlargement (> 1 cm) on followup might be associated with a higher probability of developing the first clinical decompensation of cirrhosis [60].…”

Section: Ultrasound and Colour-doppler-ultrasoundmentioning

confidence: 99%

Non-Invasive Diagnostic and Prognostic Evaluation of Liver Cirrhosis and Portal Hypertension

et al. 2011

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Abstract. Cirrhosis is the final stage of most of chronic liver diseases, and is almost invariably complicated by portal hypertension, which is the most important cause of morbidity and mortality in these patients. This review will focus on the non-invasive methods currently used in clinical practice for diagnosing liver cirrhosis and portal hypertension. The first-line techniques include physical examination, laboratory parameters, transient elastography and Doppler-US. More sophisticated imaging methods which are less commonly employed are CT scan and MRI, and new technologies which are currently under evaluation are MR elastography and acoustic radiation force imaging (ARFI). Even if none of them can replace the invasive measurement of hepatic venous pressure gradient and the endoscopic screening of gastroesophageal varices, they notably facilitate the clinical management of patients with cirrhosis and portal hypertension, and provide valuable prognostic information.

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Spleen Enlargement on Follow-Up Evaluation: A Noninvasive Predictor of Complications of Portal Hypertension in Cirrhosis

Cited by 56 publications

References 20 publications

The spleen in liver cirrhosis: revisiting an old enemy with novel targets

The spleen in liver cirrhosis: revisiting an old enemy with novel targets

Relevance of the mTOR signaling pathway in the pathophysiology of splenomegaly in rats with chronic portal hypertension

Non-Invasive Diagnostic and Prognostic Evaluation of Liver Cirrhosis and Portal Hypertension

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