Larger splenic volume (1312 cc vs 1152 cc, p=0.029) and liver volume (1514 cc vs 1143 cc, p=0.004) were also found to be predictors of endoscopically refractory variceal hemorrhage. However, this trend was not demonstrated in the sizes of the esophageal varices (6.28 mm vs 6.43 mm, p=0.370). Regarding size, the hemorrhage group had larger gastric varices compared to the control group (8.03 mm vs 6.51 mm, respectively, p=0.001). Gastric intraluminal variceal protrusion was found to be a strong CT parameter associated with refractory variceal hemorrhage (0.75 mm vs -2.91 mm, p=0.001). Two blinded radiologists reviewed the scans for the following parameters: size of varices, degree of variceal intraluminal protrusion, liver and splenic volumes, and portal vein diameter.

The objective of this study was to identify features on abdominal CT imaging associated endoscopically refractory uncontrolled variceal hemorrhage requiring portal venous intervention.īetween January 2009 to January 2018, CT scans from 64 patients who experienced endoscopically refractory variceal hemorrhage requiring intervention such as transjugular intrahepatic portosystemic shunt (TIPS) placement or retrograde transvenous obliteration (RTO) and 67 patients without variceal hemorrhage but with severe symptomatic pressure gradient proven portal hypertension were analyzed.

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