Evaluation of Clinical, Biochemical and Ultrasound Parameters in Diagnosis of Oesophageal Varices
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- Category: Vol. 78, June 2010
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Evaluation of Clinical, Biochemical and Ultrasound Parameters in Diagnosis of Oesophageal Varices,FAWZY A. KHALIL, KHALIL A. KHALIL, TAREK H. KHALIL, ADEL A. HASSAN and MOHAMAD A. SERWAH
Abstract
Background: Bleeding oesophageal varices (OV) is the most dangerous complication of liver cirrhosis and to reduce the invasive methods and burden that endoscopy units have to bear some studies attempted to identify characteristics that non-invasively predict the presence of any OV among patients with liver cirrhosis.
Aim of the Work: To assess the presence of OV using non-invasive methods (Clinical, biochemical and ultrasound pa-rameters).
Patients and Methods: After approval of our ethics com-mittee, 73 patients (47 males and 26 females, aged 20-66 years) known to have chronic liver disease (CLD) with liver cirrhosis attending the Gastroenterology Unit, Suez Canal University hospital in Ismailia were evaluated clinically, biochemically and by ultrasonographic studies and upper GI endoscopy. Clinical evaluation included detailed history and complete physical examination.
Results: Upper GI endoscopy estimated that 75.3% of the patients had OV. Presence of multiple spider naevi, palmar erythema, lower limb edema and palpable spleen are signifi-cantly more common among patients with OV. Low platelet count, low plasma albumin and prolonged PT were significant laboratory findings among patients with OV. Doppler US of hepatic vein showed significant difference between patients with and without OV regarding pattern and direction of blood flow and presence of portosystemic collaterals. Multiple spider naevi, low plasma albumin, low platelet count/spleen diameter ratio, hepatic vein flow pattern and direction of blood flow of portal vein are all independent predictors for presence of OV.
Conclusion: Clinical, biochemical and ultrasound param-eters can replace the invasive upper GI endoscopy in the detection of the presence of any OV.