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Methods: children aged 0–19 undergoing esophagogastroduodenoscopy for variceal screening or surveillance and receiving abdominopelvic ultrasound with splenic elastography; biological markers (platelets, albumin) were used to build a clinical prediction rule (CPR). Results: 80 derivation and 58 validation children were included; splenic stiffness was an independent predictor in derivation (AUC 0.83; sensitivity 0.90; specificity 0.73 at 22 kPa) but not significant in validation. Liver stiffness and CPR showed more robust predictive performance across cohorts. Conclusions: SSM alone cannot predict varices; LSM and CPR are more consistent.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/splenic-stiffness-does-not-predict-esophageal-varices-in-children-with-portal-hypertension/459308/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/splenic-stiffness-does-not-predict-esophageal-varices-in-children-with-portal-hypertension/459308.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of this study?","Question",{"text":112,"@type":113},"To assess ultrasound parameters, particularly splenic stiffness, as predictors of esophageal varices in children with portal hypertension.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were children selected and what measurements were performed?",{"text":117,"@type":113},"Children aged 0–19 underwent esophagogastroduodenoscopy and abdominopelvic ultrasound with splenic elastography; platelet count and albumin were recorded to derive a clinical prediction rule (CPR).",{"name":119,"@type":110,"acceptedAnswer":120},"Why can splenic stiffness not be used alone for prediction?",{"text":121,"@type":113},"Although splenic stiffness predicted varices in the derivation cohort, it was not significantly associated with varices at endoscopy in the validation cohort, with much lower sensitivity.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459308,1791089398,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","DOI: 10.1002/jpn3.70247  \nORIGINAL ARTICLE  \nHe patology  \nSplenic stiffness does not predict esophageal varices in children with portal hypertension  \nMargaux Jezequel1,2  | Mohamed El Fayoumi3 | Madeleine Aumar1 | Léa Tran1 | Clémence Saingier1 | Hélène Behal4 | Matthieu Antoine1 | Fréderic Gottrand1   \n1Department of Pediatric Gastroenterology Hepatology and Nutrition CHU Lille, Univ. Lille, Inserm U1286 ‐ INFINITE ‐ Institute for Translational Research in Inflammation, Lille, France  \n2Department of Pediatrics, CHU Brest, Brest, France  \n3Department of Pediatric Radiology CHU Lille, Univ. Lille, Lille, France  \n4Unité Statistique, Evaluation Economique et Data Management (SEED), Maison Régionalede la Recherche Clinique, CHU Lille, Lille, France  \nCorrespondence  \nMargaux Jezequel, Service de pédiatrie, CHU Brest, 2 Ave Foch, Brest F‐29200, France.  \n[Email:](Email: margaux.j.29@live.fr)[ margaux.j.29@live.fr](Email: margaux.j.29@live.fr)  \nFunding information None  \nAbstract  \nObjective: To investigate ultrasound parameters, particularly splenic stiffness, as predictors of pediatric esophageal varices.  \nMethods: We included all children aged 0–19 years who underwent esophagogastroduodenoscopy, for variceal screening or surveillance, and abdominopelvic ultrasound with splenic elastography measurement. We also recorded biological parameters (platelets count, albumin) to determine a clinical prediction rule (CPR) . Derivation and validation cohorts were defined according to measurement date . Receiver‐operating characteristic (ROC) statistics and sensitivity, specificity, positive predictive value, and negative predictive value for the optimal threshold value were calculated, and used to assess the performance of each parameter.  \nResults: Eighty derivation cohort children and 58 validation cohort children formed the study sample. Cohort characteristics did not differ for age, sex, distribution of varices but differ for some etiologies, abdominal surgery, spleen size, splenic stiffness measurement (SSM), ascites, and the presence of spontaneous portosystemic shunts. In the derivation cohort, splenic stiffness was the best independent predictor of esophageal varices, with an area under the ROC curve (AUC) of 0.83, a sensitivity of 0.90, and specificity of 0.73 at a threshold of 22 kPa. In the validation cohort, SSM was no longer significantly associated with esophageal varicesat endoscopy, had a lower sensitivity of 0.26, and no other threshold could be found. Liver stiffness measurement (LSM) and CPR had a correct predictive value (AUC 0.70 for LSM; 0.78 for CPR in the derivation cohort and 0.64 for LSM; 0.71 for CPR in the validation cohort) for esophageal varices .  \nConclusions: SSM cannot be used as a single parameter to predict esophageal varices. LSM and CPR despite their lower AUC appear to much more robust measures with consistent results across cohorts.  \n\n| [Correction added on 02 December 2025, after first online publication. Article format has been updated.] |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2025 The Author(s) . Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. |\n\n[156](156 | wileyonlinelibrary.com/journal/jpn3)[ |](156 | wileyonlinelibrary.com/journal/jpn3)[ wileyonlinelibrary.com/journal/jpn3](156 | wileyonlinelibrary.com/journal/jpn3) J Pediatr Gastroenterol Nutr. 2026;82:156–164.  \nJEZEQUEL  \nET AL.  \n|  \n157  \nKEYW ORDS  \nchild, clinical prediction rule, elastography, esophagogastroduodenoscopy, liver stiffness  \n1 | INTRODUCTION  \nWhile rare, pediatric portal hypertension (PH) remains the leading cause of upper gastrointesti","cbCaidqT2LsPmiFq","https://ap.wps.com/l/cbCaidqT2LsPmiFq","pdf",1118616,"English","# Objective\n# Methods\n# Results\n## Cohorts and baseline differences\n## Predictive performance\n# Conclusions","[{\"question\":\"What was the main objective of this study?\",\"answer\":\"To assess ultrasound parameters, particularly splenic stiffness, as predictors of esophageal varices in children with portal hypertension.\"},{\"question\":\"How were children selected and what measurements were performed?\",\"answer\":\"Children aged 0–19 underwent esophagogastroduodenoscopy and abdominopelvic ultrasound with splenic elastography; platelet count and albumin were recorded to derive a clinical prediction rule (CPR).\"},{\"question\":\"Why can splenic stiffness not be used alone for prediction?\",\"answer\":\"Although splenic stiffness predicted varices in the derivation cohort, it was not significantly associated with varices at endoscopy in the validation cohort, with much lower sensitivity.\"}]","Splenic stiffness does not predict esophageal varices in children with portal hypertension | PDF",1790755646,23]