Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension

Early identification of clinically significant portal hypertension (CSPH) is crucial in cirrhosis, as it is the primary underlying mechanism of cirrhosis complications. One such complication is esophageal varices, which are associated with high morbidity and mortality. Hepatic venous pressure gradi...

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Main Author: Irsan Hasan
Format: Article
Language:English
Published: Interna Publishing 2024-10-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2897
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author Irsan Hasan
author_facet Irsan Hasan
author_sort Irsan Hasan
collection DOAJ
description Early identification of clinically significant portal hypertension (CSPH) is crucial in cirrhosis, as it is the primary underlying mechanism of cirrhosis complications. One such complication is esophageal varices, which are associated with high morbidity and mortality. Hepatic venous pressure gradient (HVPG) measurements and endoscopy, considered the gold standard for these conditions, are invasive methods that are limited, costly, and inconvenient. To address this challenge, a combination of non-invasive tests can be employed to predict CSPH and esophageal varices. A validated approach involves combining liver stiffness measurement (LSM) by transient elastography (TE) with platelet count. Additionally, spleen stiffness measurement (SSM) has emerged as a promising method for evaluating high-risk varices, as reported by Nababan et al. Therefore, non-invasive methods can be utilized to identify patients who need invasive procedures or potentially replace invasive procedures altogether. 
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series Acta Medica Indonesiana
spelling doaj-art-2f5b20859b3b423983d5915a23c8d97e2025-08-20T02:37:14ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322024-10-01563Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal HypertensionIrsan Hasan0Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Early identification of clinically significant portal hypertension (CSPH) is crucial in cirrhosis, as it is the primary underlying mechanism of cirrhosis complications. One such complication is esophageal varices, which are associated with high morbidity and mortality. Hepatic venous pressure gradient (HVPG) measurements and endoscopy, considered the gold standard for these conditions, are invasive methods that are limited, costly, and inconvenient. To address this challenge, a combination of non-invasive tests can be employed to predict CSPH and esophageal varices. A validated approach involves combining liver stiffness measurement (LSM) by transient elastography (TE) with platelet count. Additionally, spleen stiffness measurement (SSM) has emerged as a promising method for evaluating high-risk varices, as reported by Nababan et al. Therefore, non-invasive methods can be utilized to identify patients who need invasive procedures or potentially replace invasive procedures altogether.  http://www.actamedindones.org/index.php/ijim/article/view/2897Cirrhosisendoscopyesophageal variceshepatic venous pressure gradientportal hypertensionliver stiffness
spellingShingle Irsan Hasan
Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension
Acta Medica Indonesiana
Cirrhosis
endoscopy
esophageal varices
hepatic venous pressure gradient
portal hypertension
liver stiffness
title Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension
title_full Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension
title_fullStr Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension
title_full_unstemmed Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension
title_short Cirrhosis Management: Utilization and Optimizing Non-Invasive Tests in Portal Hypertension
title_sort cirrhosis management utilization and optimizing non invasive tests in portal hypertension
topic Cirrhosis
endoscopy
esophageal varices
hepatic venous pressure gradient
portal hypertension
liver stiffness
url http://www.actamedindones.org/index.php/ijim/article/view/2897
work_keys_str_mv AT irsanhasan cirrhosismanagementutilizationandoptimizingnoninvasivetestsinportalhypertension