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ORIGINAL ARTICLE
Year : 2019  |  Volume : 31  |  Issue : 4  |  Page : 536-543

Noninvasive parameters for assessment of esophageal varices


1 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
2 Department of Radiodiagnosis, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
3 Elmahalla Hepatology Educational Hospital, Egypt

Correspondence Address:
MD Elsayed I Elshayeb
Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejim.ejim_25_19

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Objective This study aims to assess esophageal varices (EV) by noninvasive parameters in patients with liver cirrhosis. Background The current guidelines recommend the screening of all cirrhotic patients by endoscopy for EV, but repeated endoscopic examinations are unpleasant for patients and have a high cost impact and burden on endoscopic units. Therefore, there is a particular need for noninvasive predictors of EV. Patients and methods A total of 120 cirrhotic patients were enrolled in this study and were divided into three groups: 40 cirrhotic patients with EV and a history of upper gastrointestinal bleeding, 40 cirrhotic patients with EV without a history of upper gastrointestinal bleeding, and 40 cirrhotic patients without EV. All patients in the study were subjected to an assessment of history, clinical examination, routine laboratory investigation, abdominal ultrasound, and upper gastrointestinal endoscopy. Results Serum albumin at cut-off less than 3.65 g/dl, platelet count at cut-off less than 99 000/mm3, platelet count/spleen diameter ratio (PC/SD) at cut-off less than 919.6, aspartate aminotransferase-to-platelet ratio index at cut-off greater than 1.14, spleen longitudinal diameter at cut-off more than 140.5 mm, portal vein diameter at cut-off more than 15.2 mm, and prothrombin time at cut-off more than 15.1 s are significant in the prediction of EV. North Italian Endoscopy Club Index at cut-off more than 25.4, platelet count at cut-off less than 74 000/mm3, and PC/SD at cut-off 851.6 are significant in the prediction of variceal bleeding risk. Conclusion Serum albumin, platelet count, PC/SD ratio, aspartate aminotransferase-to-platelet ratio index, spleen longitudinal diameter, portal vein diameter, prothrombin time, and Child score can provide information that can help in the prediction of the presence of EVs in patients with liver cirrhosis. North Italian Endoscopy Club Index, platelet count, and PC/SD ratio can provide information that can help in the prediction of variceal bleeding risk in patients with liver cirrhosis.


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