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

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
How to Cite
BHATTARAI, Subash et al. Non-Invasive Predictors of Gastro-Oesophageal Varices. Journal of Nepal Medical Association, [S.l.], v. 56, n. 207, p. 298-303, sep. 2017. ISSN 1815-672X. Available at: <http://jnma.com.np/jnma/index.php/jnma/article/view/3202>. Date accessed: 23 oct. 2017.