PREDICTORS OF ESOPHAGEAL VARICES IN PATIENTS OF LIVER CIRRHOSIS

Abstract

Objective: To identify non-endoscopic predictors of esophageal varices in patients with liver cirrhosis.
Material and Methods: This observational and analytical study was carried at GI and Liver Clinic, Saeed Anwar Medical Center, Dabgari Gardens, Peshawar from January 2006 to August 2006. Seventythree patients with established cirrhosis and no history of variceal bleeding were evaluated for predetermined variables and underwent endoscopy to look for esophageal varices.
Results: Out of 73 patients, 51 (69.9%) were males and 22 (30.1%) were females. Forty-four (60.3%) patients were having esophageal varices on endoscopy and 29 (39.7%) patients were having no varices. Out of 44 patients, small varices were found in 28 (63.6%) patients while large varices were found in 16 (36.4%) patients. Platelet count < 65 x 103/μL, serum albumin < 2.2 g/dl and portal vein diameter > 13 mm on ultrasound were found to have significant predictive value for large varices.

Conclusion: Platelet count less than 65 x 103/μL, serum albumin less than 2.2 g/dl and portal vein diameter more than 13 mm on ultrasound are independent and significant predictors of esophageal varices on endoscopy. Therefore screening endoscopy must be done in all patients with liver cirrhosis who have no
history of GI bleeding but any of these predictors.