Are there clinical contexts where you would not use spleen stiffness to drive endoscopy/NSBB decisions because you suspect the SSM signal is dominated by splenic congestion/hyperdynamic circulation rather than portal pressure, and how do you identify those contexts at the bedside?

Spleen stiffness measurements have recently become available when the technology was added to the vibration-controlled transient elastography equipment that measures liver stiffness. It is not invasive, and elevated spleen stiffness has been added to the Baveno criteria and other professional societ...