Non-Invasive Predictors of Gastro-Oesophageal Varices

  • Subash Bhattarai Department of Medical Gastroenterology, College of Medical Sciences, Chitwan, Nepal
  • Khus Raj Dewan Department of Medical Gastroenterology, College of Medical Sciences, Chitwan, Nepal
  • Gaurav Shrestha Department of Medical Gastroenterology, College of Medical Sciences, Chitwan, Nepal
  • Bhanumati Saikia Patowary Department of Medical Gastroenterology, College of Medical Sciences, Chitwan, Nepal
Keywords: cirrhosis of liver ;endoscopy; gastro-oesophageal varices, non invasive predictors

Abstract

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

respectively.

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

and management.

Keywords: cirrhosis of liver; endoscopy; gastro-oesophageal varices; non-invasive predictors.

Published
2017-09-30
Section
Original Article