ESOPHAGEAL VARICES;

NON-ENDOSCOPIC PREDICTION OF PRESENCE

Abstract

Bleeding from esophageal varices is associated with high morbidity and mortality. It is currently recommended that all
patients with liver cirrhosis undergo upper gastrointestinal endoscopy to identify those who have esophageal varices. This approach
leads to unnecessary endoscopies. There is need to evaluate clinical, laboratory and imaging parameters that may predict the presence of
esophageal varices and help select patients for endoscopy. Objective: Identify hematological, biochemical and ultasonographic
predictors of oesophageal varices in patients of cirrhosis. Study design: Cross sectional Descriptive study. Setting: Department of
General Medicine and Gastroenterology unit 1, Services Hospital, Lahore. Duration of study: 6 months (April 01, 2007 – September 30,
2007). Sample size: Study was done on One hundred patients who had established cirrhosis with oesophageal varices. Results: Majority
(77%) were male who had evidence of esophageal varices. Hematemesis was the presenting complaint in 75% of patients and majority
(83%) had clinically palpable spleen. Esophageal varices were present in 75% of patents who had platelet count <100, 000. In patients
who had portal vein diameter of >20mm 41% had evidence of esophageal varices. Splenic measurement of >13cm was associated with
maximum number of cases of esophageal varices i.e 82%. Conclusion: It is concluded from the study that male gender, clinically palpable
spleen, low platelet count, portal vein diameter and splenic measurement can be used as non invasive parameters to predict esophageal
varices reducing the need of unnecessary endoscopies.