CORRELATION BETWEEN SPLENOMEGALY AND PRESENCE OF ESOPHAGEAL VARICES IN PEDIATRICS CHRONIC LIVER DISEASE (CLD) PATIENTS

Abstract

Objective: To determine the correlation between the degree of splenomegaly and the presence of esophageal varices in pediatric patients with chronic liver disease. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pediatric Gastroenterology, Combined Military Hospital, Rawalpindi, Pakistan, from 10 October, 2025 to 10 April, 2026. Methodology: The study included 23 children aged 1–12 years diagnosed with chronic liver disease and ultrasound-documented splenomegaly. Patients were categorized into three groups based on the severity of splenomegaly: Group 1 (1–2.9 SD), Group 2 (3–5.9 SD), and Group 3 (≥6 SD). All patients underwent esophagogastroduodenoscopy (EGD) to identify esophageal varices. Statistical analysis was performed using chi-square and Pearson’s correlation to assess the relationship between varices and clinical markers including spleen size, platelet count, and platelet count to splenic diameter (PC/SD) ratio (p<0.05 significant). Results:  Mean age was 6  years ± 3 Standard deviation. 60.9% were male. Esophageal varices were present in 78.2% (n=18) of the total population. Varices were identified in 71.4% of Group 1, 80% of Group 2, and 83.3% of Group 3 patients. There was no statistically significant correlation between the degree of splenomegaly and the presence of varices (p=0.618). Furthermore, no significant associations were found for Child-Pugh class (p=0.914), platelet count (p=0.822), or the PC/SD ratio (p=0.474). Conclusion: Splenomegaly and associated non-invasive hematological markers are not reliable predictors for the presence of esophageal varices in children. Routine surveillance endoscopy remains necessary for accurate diagnosis in pediatric chronic liver disease.