Clinical Trials Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8568-8577
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8568
Computed tomography combined with gastroscopy for assessment of pancreatic segmental portal hypertension
Yu-Li Wang, Han-Wen Zhang, Fan Lin
Yu-Li Wang, Han-Wen Zhang, Fan Lin, Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
Author contributions: Zhang HW contributed to the conception of the study; Lin F performed the data analyses and wrote the manuscript; Wang YL helped perform the analysis with constructive discussions.
Supported by Shenzhen Science and Technology Plan Project, No. JCYJ20180228163333734.
Institutional review board statement: This study was approved by the local ethics committee (Ethics Committee of Shenzhen Second People's Hospital), No. 20211108009.
Clinical trial registration statement: This study is registered at Ethics Committee of Shenzhen Second People's Hospital. This study is registered at Chinese Clinical Trial Registry. The registration identification number is ChiCTR2100049175.
Informed consent statement: This study included completely anonymous data, and the ethics committee agreed to waive the patient's right of informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data used in this study are included in the article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Han-Wen Zhang, MD, Doctor, Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, No. 3002 Sungangxi Road, Shenzhen 518035, Guangdong Province, China. zhwstarcraft@outlook.com
Received: February 26, 2022
Peer-review started: February 26, 2022
First decision: May 11, 2022
Revised: May 13, 2022
Accepted: July 22, 2022
Article in press: July 22, 2022
Published online: August 26, 2022
Processing time: 170 Days and 12.3 Hours
ARTICLE HIGHLIGHTS
Research background

Pancreatic segmental portal hypertension (PSPH) is the only type of portal hypertension that can be completely cured.

Research motivation

PSPH can easily cause varicose veins in the esophagus and stomach and hemorrhage in the digestive tract.

Research objectives

To explore the application of computed tomography (CT) to examine the characteristics of PSPH and assess the risk level.

Research methods

This was a retrospective analysis of CT images of 22 patients diagnosed with PSPH at our center. Spearman correlation analysis was performed using the range of esophageal and gastric varices (measured by the vertical gastric wall), the ratio of the width of the splenic portal vein to that of the compression site (S/C ratio), the degree of splenomegaly, and the stage determined by gastroscopy. The study examined whether patients experienced gastrointestinal bleeding within 2 wk and combined CT and gastroscopy to explore the connection between bleeding and CT findings.

Research results

The range of esophageal and gastric varices showed the best correlation in the diagnosis of PSPH (P < 0.001), and the S/C ratio (P = 0.007) was correlated with the degree of splenomegaly (P = 0.021) and PSPH (P < 0.05). The study revealed that male patients were more likely than females to progress to grade 2 or grade 3 as determined by gastroscopy. CT imaging demonstrated excellent performance, with an area under the curve of 0.879.

Research conclusions

CT can be used to effectively analyze the imaging signs of PSPH, and CT combined with gastroscopy can effectively predict the risk level of gastrointestinal bleeding.

Research perspectives

This was a detailed clinical imaging study (computed tomography, CT) of PSPH, the only curable form of portal hypertension. CT is of great significance in diagnosing and treating PSPH.