{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:06:00Z","timestamp":1792080360131,"version":"4.4.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Indian J Gastroenterol"],"published-print":{"date-parts":[[2020,12]]},"DOI":"10.1007\/s12664-020-01099-8","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T14:07:59Z","timestamp":1606226879000},"page":"576-583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Splenic stiffness and platelet count to predict varices needing treatment in pediatric extrahepatic\u00a0portal vein obstruction"],"prefix":"10.1007","volume":"39","author":[{"given":"Srinivas Srinidhi","family":"Vadlapudi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2108-9054","authenticated-orcid":false,"given":"Barath","family":"Jagadisan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Ananthkrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Narayanaswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,24]]},"reference":[{"key":"1099_CR1","doi-asserted-by":"crossref","unstructured":"Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology. 2017;65:310\u201335.\u00a0","DOI":"10.1002\/hep.28906"},{"key":"1099_CR2","doi-asserted-by":"crossref","unstructured":"Duch\u00e9 M, Ducot B, Ackermann O, Gu\u00e9rin F, Jacquemin E, Bernard O. Portal hypertension in children: High-risk varices, primary prophylaxis and consequences of bleeding. J Hepatol. 2017;66:320-7.\u00a0","DOI":"10.1016\/j.jhep.2016.09.006"},{"key":"1099_CR3","doi-asserted-by":"crossref","unstructured":"Garcia-Tsao G, Sanyal AJ, Grace ND, et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46:922\u201338.","DOI":"10.1002\/hep.21907"},{"key":"1099_CR4","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","volume":"63","author":"R de Franchis","year":"2015","unstructured":"de Franchis R. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743\u201352.","journal-title":"J Hepatol"},{"key":"1099_CR5","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1080\/17474124.2017.1374852","volume":"12","author":"D Roccarina","year":"2018","unstructured":"Roccarina D, Rosselli M, Genesca J, Tsochatzis EA. Elastography methods for the non-invasive assessment of portal hypertension. Expert Rev Gastroenterol Hepatol. 2018;12:155\u201364.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"1099_CR6","doi-asserted-by":"crossref","unstructured":"Sarin SK, Sollano JD, Chawla YK, et al. Consensus on extra-hepatic portal vein obstruction. Liver Int. 2006;26:512\u20139.","DOI":"10.1111\/j.1478-3231.2006.01269.x"},{"key":"1099_CR7","doi-asserted-by":"crossref","unstructured":"Madhusudhan KS, Sharma R, Kilambi R, et al. 2D shear wave elastography of liver in patients with primary extrahepatic portal vein obstruction. J Clin Exp Hepatol. 2017;7:23\u20137.","DOI":"10.1016\/j.jceh.2016.12.001"},{"key":"1099_CR8","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/MPG.0000000000002069","volume":"67","author":"H Sutton","year":"2018","unstructured":"Sutton H, Fitzpatrick E, Davenport M, et al. Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. J Pediatr Gastroenterol Nutr. 2018;67:446\u201351.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"1099_CR9","doi-asserted-by":"crossref","unstructured":"Adami MR, Kieling CO, Schwengber FP, Hirakata VN, Vieira SMG. Noninvasive methods of predicting large esophageal varices in children with intrahepatic portal hypertension. J Pediatr Gastroenterol Nutr. 2018;66:442\u20136.\u00a0","DOI":"10.1097\/MPG.0000000000001841"},{"key":"1099_CR10","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1097\/MPG.0000000000000400","volume":"59","author":"I Goldschmidt","year":"2014","unstructured":"Goldschmidt I, Brauch C, Poynard T, Baumann U. Spleen stiffness measurement by transient elastography to diagnose portal hypertension in children. J Pediatr Gastroenterol Nutr. 2014;59:197\u2013203.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"1099_CR11","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/1471-230X-11-41","volume":"11","author":"V Chongsrisawat","year":"2011","unstructured":"Chongsrisawat V, Vejapipat P, Siripon N, Poovorawan Y. Transient elastography for predicting esophageal\/gastric varices in children with biliary atresia. BMC Gastroenterol. 2011;11:41.","journal-title":"BMC Gastroenterol"},{"key":"1099_CR12","doi-asserted-by":"crossref","unstructured":"El-Sayed R, El-Ela MA, El-Raziky MS, Helmy H, El-Ghaffar AA, El-Karaksy H. Relation of serum levels of thrombopoietin to thrombocytopenia in extrahepatic portal vein obstruction versus cirrhotic children. J Pediatr Hematol Oncol. 2011;33:e267\u201370.\u00a0","DOI":"10.1097\/MPH.0b013e31821d80be"},{"key":"1099_CR13","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1007\/s13244-016-0514-5","volume":"7","author":"C Bruno","year":"2016","unstructured":"Bruno C, Minniti S, Bucci A, Pozzi Mucelli R. ARFI: from basic principles to clinical applications in diffuse chronic disease\u2014a review. Insights Imaging. 2016;7:735\u201346.","journal-title":"Insights Imaging"},{"key":"1099_CR14","doi-asserted-by":"crossref","unstructured":"Salzl P, Reiberger T, Ferlitsch M, et al. Evaluation of portal hypertension and varices by acoustic radiation force impulse imaging of the liver compared to transient elastography and AST to platelet ratio index. Ultraschall Med. 2014;35:528\u201333.\u00a0","DOI":"10.1055\/s-0034-1366506"},{"key":"1099_CR15","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1148\/radiol.12111046","volume":"263","author":"P Sharma","year":"2012","unstructured":"Sharma P, Mishra SR, Kumar M, Sharma BC, Sarin SK. Liver and spleen stiffness in patients with extrahepatic portal vein obstruction. Radiology. 2012;263:893\u20139.\u00a0","journal-title":"Radiology."},{"key":"1099_CR16","doi-asserted-by":"crossref","unstructured":"Fontanilla T, Ca\u00f1as T, Macia A, et al. Normal values of liver shear wave velocity in healthy children assessed by acoustic radiation force impulse imaging using a convex probe and a linear probe. Ultrasound Med Biol. 2014;40:470\u20137.","DOI":"10.1016\/j.ultrasmedbio.2013.10.024"},{"key":"1099_CR17","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1097\/MPG.0000000000000539","volume":"59","author":"H Matos","year":"2014","unstructured":"Matos H, Trindade A, Noruegas MJ. Acoustic radiation force impulse imaging in paediatric patients: normal liver values. J Pediatr Gastroenterol Nutr. 2014;59:684\u20138.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"1099_CR18","doi-asserted-by":"crossref","unstructured":"Eiler J, Kleinholdermann U, Albers D, et al. Standard value of ultrasound elastography using acoustic radiation force impulse imaging (ARFI) in healthy liver tissue of children and adolescents. Ultraschall Med. 2012;33:474\u20139.\u00a0","DOI":"10.1055\/s-0032-1313145"},{"key":"1099_CR19","unstructured":"Popescu A, Sporea I, Sirli R, et al. The mean values of liver stiffness assessed by acoustic radiation force impulse elastography in normal subjects. Med Ultrason. 2011;13:33\u20137."},{"key":"1099_CR20","doi-asserted-by":"publisher","first-page":"2173","DOI":"10.1002\/hep.28824","volume":"64","author":"JG Abraldes","year":"2016","unstructured":"Abraldes JG, Bureau C, Stefanescu H, et al. Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: the \u201cAnticipate\u201d study. Hepatology. 2016;64:2173\u201384.","journal-title":"Hepatology"},{"key":"1099_CR21","doi-asserted-by":"crossref","unstructured":"Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017;64:319\u201334.","DOI":"10.1097\/MPG.0000000000001482"},{"key":"1099_CR22","doi-asserted-by":"crossref","unstructured":"Hanquinet S, Courvoisier D, Kanavaki A, Dhouib A, Anooshiravani M. Acoustic radiation force impulse imaging-normal values of liver stiffness in healthy children. Pediatr Radiol. 2013;43:539\u201344.\u00a0","DOI":"10.1007\/s00247-012-2553-5"},{"key":"1099_CR23","doi-asserted-by":"crossref","unstructured":"Shneider BL, de Ville de Goyet J, Leung DH, et al. Primary prophylaxis of variceal bleeding in children and the role of MesoRex bypass: summary of the Baveno VI pediatric satellite symposium. Hepatology. 2016;63:1368\u201380.","DOI":"10.1002\/hep.28153"},{"key":"1099_CR24","first-page":"94","volume":"32","author":"U Poddar","year":"2011","unstructured":"Poddar U, Borkar V. Management of extra hepatic portal venous obstruction (EHPVO): current strategies. Trop Gastroenterol. 2011;32:94\u2013102.","journal-title":"Trop Gastroenterol"},{"key":"1099_CR25","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1097\/00005176-199701000-00012","volume":"24","author":"SK Yachha","year":"1997","unstructured":"Yachha SK, Sharma BC, Kumar M, Khanduri A. Endoscopic sclerotherapy for esophageal varices in children with extrahepatic portal venous obstruction: a follow-up study. J Pediatr Gastroenterol Nutr. 1997;24:49\u201352.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"1099_CR26","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.cld.2014.01.009","volume":"18","author":"SK Sarin","year":"2014","unstructured":"Sarin SK, Khanna R. Non-cirrhotic portal hypertension. Clin Liver Dis. 2014;18:451\u201376.","journal-title":"Clin Liver Dis"},{"key":"1099_CR27","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1097\/00005176-199711000-00006","volume":"25","author":"RN Mehrotra","year":"1997","unstructured":"Mehrotra RN, Bhatia V, Dabadghao P, Yachha SK. Extrahepatic portal vein obstruction in children: anthropometry, growth hormone, and insulin-like growth factor I. J Pediatr Gastroenterol Nutr. 1997;25:520\u20133.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"1099_CR28","doi-asserted-by":"crossref","unstructured":"Suresh MV, Jagadisan B, Kandasamy P, Senthilkumar GP. Stroop test validation to screen for minimal hepatic encephalopathy in pediatric extrahepatic portal venous obstruction. J Pediatr Gastroenterol Nutr. 2018;66:802\u20137.\u00a0","DOI":"10.1097\/MPG.0000000000001895"},{"key":"1099_CR29","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1111\/j.1478-3231.2003.00879.x","volume":"23","author":"M Rangari","year":"2003","unstructured":"Rangari M, Gupta R, Jain M, Malhotra V, Sarin SK. Hepatic dysfunction in patients with extrahepatic portal venous obstruction. Liver Int. 2003;23:434\u20139.\u00a0","journal-title":"Liver Int"},{"key":"1099_CR30","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1002\/hep.1840180416","volume":"18","author":"SC Robson","year":"1993","unstructured":"Robson SC, Kahn D, Kruskal J, Bird AR, Kirsch RE. Disordered hemostasis in extrahepatic portal hypertension. Hepatology. 1993;18:853\u20137.\u00a0","journal-title":"Hepatology."},{"key":"1099_CR31","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1067\/mpd.2003.93","volume":"142","author":"CL Mack","year":"2003","unstructured":"Mack CL, Superina RA, Whitington PF. Surgical restoration of portal flow corrects procoagulant and anticoagulant deficiencies associated with extrahepatic portal vein thrombosis. J Pediatr. 2003;142:197\u20139.","journal-title":"J Pediatr"},{"key":"1099_CR32","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1046\/j.1440-1746.2001.02392.x","volume":"16","author":"JS Bajaj","year":"2001","unstructured":"Bajaj JS, Bhattacharjee J, Sarin SK. Coagulation profile and platelet function in patients with extrahepatic portal vein obstruction and non-cirrhotic portal fibrosis. J Gastroenterol Hepatol. 2001;16:641\u20136.","journal-title":"J Gastroenterol Hepatol"},{"key":"1099_CR33","doi-asserted-by":"crossref","unstructured":"Vilgrain V, Condat B, Bureau C, et al. Atrophy-hypertrophy complex in patients with cavernous transformation of the portal vein: CT evaluation. Radiology. 2006;241:149\u201355.","DOI":"10.1148\/radiol.2411051102"},{"key":"1099_CR34","doi-asserted-by":"crossref","unstructured":"Alcantara RV, Yamada RM, De Tommaso AM, Bellomo-Brand\u00e3o MA, Hessel G. Non-invasive predictors of esophageous varices in children and adolescents with chronic liver disease or extrahepatic portal venous obstruction. J Pediatr (Rio J). 2012;88:341\u20136.\u00a0","DOI":"10.2223\/JPED.2205"},{"key":"1099_CR35","doi-asserted-by":"publisher","first-page":"20180401","DOI":"10.1259\/bjr.20180401","volume":"91","author":"KS Madhusudhan","year":"2018","unstructured":"Madhusudhan KS, Kilambi R, Shalimar, et al. Measurement of splenic stiffness by 2D-shear wave elastography in patients with extrahepatic portal vein obstruction. Br J Radiol. 2018;91:20180401.","journal-title":"Br J Radiol"},{"key":"1099_CR36","doi-asserted-by":"publisher","first-page":"e1031","DOI":"10.1097\/MD.0000000000001031","volume":"94","author":"HY Kim","year":"2015","unstructured":"Kim HY, Jin EH, Kim W, et al. The role of spleen stiffness in determining the severity and bleeding risk of esophageal varices in cirrhotic patients. Medicine (Baltimore). 2015;94:e1031.","journal-title":"Medicine (Baltimore)"},{"key":"1099_CR37","doi-asserted-by":"crossref","unstructured":"Takuma Y, Nouso K, Morimoto Y, et al. Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. Gastroenterology. 2013;144:92\u2013101.","DOI":"10.1053\/j.gastro.2012.09.049"},{"key":"1099_CR38","doi-asserted-by":"crossref","unstructured":"Wiles R, Patanwala I, Hankinson B, et al. Can acoustic radiation force imaging of the liver and spleen predict the presence of gastroesophageal varices? Clin Radiol. 2018;73:1046\u201351.","DOI":"10.1016\/j.crad.2018.07.199"},{"key":"1099_CR39","unstructured":"Bota S, Sporea I, Sirli R, et al. Spleen assessment by acoustic radiation force impulse elastography (ARFI) for prediction of liver cirrhosis and portal hypertension. Med Ultrason. 2010;12:213\u20137."},{"key":"1099_CR40","doi-asserted-by":"crossref","unstructured":"Singh S, Eaton JE, Murad MH, Tanaka H, Iijima H, Talwalkar JA. Accuracy of spleen stiffness measurement in detection of esophageal varices in patients with chronic liver disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12:935\u201345.e4.\u00a0","DOI":"10.1016\/j.cgh.2013.09.013"},{"key":"1099_CR41","doi-asserted-by":"publisher","first-page":"122","DOI":"10.2214\/AJR.07.3504","volume":"193","author":"JA Talwalkar","year":"2009","unstructured":"Talwalkar JA, Yin M, Venkatesh S, et al. Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR Am J Roentgenol. 2009;193:122\u20137.","journal-title":"AJR Am J Roentgenol"},{"key":"1099_CR42","doi-asserted-by":"crossref","unstructured":"Stefanescu H, Grigorescu M, Lupsor M, Procopet B, Maniu A, Badea R. Spleen stiffness measurement using Fibroscan for the noninvasive assessment of esophageal varices in liver cirrhosis patients. J Gastroenterol Hepatol. 2011;26:164\u201370.\u00a0","DOI":"10.1111\/j.1440-1746.2010.06325.x"},{"key":"1099_CR43","doi-asserted-by":"crossref","unstructured":"Ravaioli F, Montagnani M, Lisotti A, Festi D, Mazzella G, Azzaroli F. Noninvasive assessment of portal hypertension in advanced chronic liver disease: An update. Gastroenterol Res Pract. 2018;2018:4202091.\u00a0","DOI":"10.1155\/2018\/4202091"},{"key":"1099_CR44","doi-asserted-by":"crossref","unstructured":"Goulis J, Chau TN, Jordan S, et al. Thrombopoietin concentrations are low in patients with cirrhosis and thrombocytopenia and are restored after orthotopic liver transplantation. Gut. 1999;44:754\u20138.","DOI":"10.1136\/gut.44.5.754"}],"container-title":["Indian Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12664-020-01099-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s12664-020-01099-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12664-020-01099-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T02:15:02Z","timestamp":1612491302000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s12664-020-01099-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,24]]},"references-count":44,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1099"],"URL":"https:\/\/doi.org\/10.1007\/s12664-020-01099-8","relation":{},"ISSN":["0254-8860","0975-0711"],"issn-type":[{"value":"0254-8860","type":"print"},{"value":"0975-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,24]]},"assertion":[{"value":"30 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"SSV, BJ, RA and SN\u00a0declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.The study had been approved by the institute ethics committee that complies with international standards and is registered with the government of India (JIP\/IEC\/2016\/1082).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}},{"value":"The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology\u00a0or the printer\/publishers are responsible for the results\/findings and content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}