Spleen Stiffness as Predictor of Esophageal Varices in Cirrhosis of Different Etiologies.

The purpose of this study is to determine whether esophageal varices (EV) can be identified through the evaluation of spleen stiffness (SSM) via acoustic radiation force impulse (ARFI). A total of 135 patients suffering from cirrhosis underwent a clinical exam, laboratory tests, abdominal ultrasound, liver stiffness (LSM) measurement, SSM evaluation and upper gastrointestinal endoscopy. Based on the endoscopy results, the patients were classified into three groups: those with no evident EV, those with small EV and those with varices needing treatment (VNT). Patients with EV of any grade had significantly higher average SSM values over those with no EV (3.37 m/s versus 2.79 m/s, p-value < 0.001), while patients with VNT showed an even greater difference (3.96 m/s versus 2.93 m/s, p-value < 0.001). SSM proved to be an excellent method of predicting patients with VNT.

The functional sphincter of Oddi disorder.

The sphincter of Oddi disorder (SOD) has been a controversial subject for many years, about which a lot has been written. However, new findings mainly using Endoscopic Retrograde Cholangiopancreatography (ERCP) and sphincter of Oddi manometry (SOM) demonstrate the fact of this diagnostic. SOD is just a part of a larger pathology, the tfunctional gastrointestinal disorders, which have been reconsidered as an important part of gastrointestinal diseases. For a better understanding, the American Gastroenterology Association Institute created a new classification of The Functional Gastrointestinal Disorders in 2006, Rome III Classification, in which the SOD is grouped in the functional biliary disorders (category E). The term SOD is used to define manometric abnormalities in patients who have signs and symptoms consistent with a biliary or pancreatic ductal origin. Based on the pathogenic mechanism and manometry findings, the SOD is separated into two groups: a group characterized by a stenotic pattern (anatomical abnormality) and a second group with a dyskinetic pattern functional abnormality). The purpose of this article is to construct a short presentation of the main aspects regarding tfunctional SOD (E2 and E3 after Rome III Classificatio).