Non-Invasive Predictors of Gastro-Oesophageal Varices
Introduction: The worldwide accepted tool for screening and monitoring gastro-oesophageal varices
in patients with liver cirrhosis is upper gastrointestinal endoscopy. Endoscopy needs clinical expertise
and has got its own procedure related complications. Repeated endoscopies may be expensive and
patients tend to develop poor compliance. This study was undertaken to establish the role of noninvasive
parameters in predicting gastro-esophageal varices.
Methods: Two hundred patients with clinical features, laboratory and sonological findings
suggestive of cirrhosis of liver and endoscopic evidence of portal hypertension were included in the
study. Blood parameters like serum albumin, international normalized ratio (INR), platelets count
and ultrasonography assessments of portal vein diameter and spleen size were compared with
presence of gastro-oesophageal varices.
Results: At cutoff point of 2.55g/dl, serum albumin had high specificity of 99% whereas platelets
count <1,44,000/mm3 had 87.9% sensitivity for presence of oesophageal varices. Sensitivities of
92.72% and 94.5% while specificities of 90% and 75% were detected for presence of oesophageal
varices when the cutoff values for portal vein diameter and spleen size were 12.25 mm and 13.9 cm
Conclusions: Measurements of serum albumin, platelets count, portal vein diameter and spleen size
by ultrasonography can be recommended as a non-invasive predictor for gastro-oesophageal varices
in cirrhosis of liver. All these non-invasive parameters could be useful to patients with liver cirrhosis
with portal hypertension in predicting presence of varices as well as in long-term clinical monitoring
Keywords: cirrhosis of liver; endoscopy; gastro-oesophageal varices; non-invasive predictors.
Copyright (c) 2017 Subash Bhattarai, Khus Raj Dewan, Gaurav Shrestha, Bhanumati Saikia Patowary
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