Paediatric Surgery (Ukraine). 2025. 2(87): 44-51. doi: 10.15574/PS.2025.2(87).4451
Kozlov S. M.¹, Kosei N. V.^2,3, Kondratiuk V. A.⁴, Sydorenko V. M.¹, Mnevets R. O.^3,5, Kozlov O. S.⁶, Yakovenko N. O.^6,7, Posokhov D. M.^8
1Bogomolets National Medical University, Kyiv, Ukraine
²SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv
³SI “Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine”, Kyiv
⁴National Research Centre of Surgery and Transplantation named after O.O. Shalimov, Kyiv, Ukraine
⁵Taras Shevchenko National University of Kyiv, Ukraine
⁶Shupyk National Healthcare University of Ukraine, Kyiv
⁷CNE «Kyiv Regional Clinical Hospital» of the Kyiv Regional Council, Ukraine
⁸Kyiv City Clinical Hospital No. 12, Ukraine

For citation: Kozlov SM, Kosei NV, Kondratiuk VA, Sydorenko VM, Mnevets RO, Kozlov OS. et al. (2025). Organization of medical care for pregnant women, fetuses and children with critical congenital malformations in a multifunctional perinatal center. Paediatric Surgery (Ukraine). 2(87): 44-51. doi: 10.15574/PS.2025.2(87).4451.
Article received: Mar 21, 2025. Accepted for publication: Jun 10, 2025.

Portal hypertension (PH) is a common complication of liver cirrhosis, leading to the development of esophageal and gastric varices (GOV), ascites, and hypersplenism. One of the most prevalent manifestations of complicated portal hypertension (CPH) is splenomegaly (SMG), observed in 80-90% of patients. Spleen volume (SV) is considered an integrated marker of splanchnic hemodynamics and a potential predictor of the severity of PH.
Aim – to investigate the prevalence of SMG in patients with diagnosed CPH and to evaluate its predictive value for the presence of GOV.
Materials and methods. A total of 187 patients with acquired chronic liver disease (ACLD) (fibrosis or cirrhosis) and clinically significant portal hypertension (CSPH) with confirmed grade II-III GOV were included, along with 46 healthy controls (CG). SV was measured by ultrasound B-mode by determining three linear dimensions and using automated calculation. The Child-Pugh score was used to assess liver functional status.  For evaluating the prediction model parameters of GOV, ROC analysis with calculation of AUC was applied.
Results. SMG (SV >314 cm³) was detected in 98% of patients with GOV and in none of the CG. The mean SV in the study group was 5.8 times higher than in CG (853.3±404.3 vs.146±56.9 cm³), with median values of 765 cm³ and 140 cm³, respectively (p<0.0001). The area under the ROC curve (AUC) for SV as a predictor of GOV was 0.995, with a sensitivity of 98.9% and specificity of 100% at the cut-off point of 293 cm³.
Conclusions. The high prognostic value of SV as an independent predictor of the presence of GOV in patients with ACLD and CPH has been confirmed. No association between SV and the degree of the liver dysfunction was established.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. Informed consent was obtained from patients.
The authors declare no conflict of interest.
Keywords: splenomegaly, portal hypertension, prediction, gastroesophageal varices, spleen volume, non-invasive diagnostics.

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