Detection of esophageal varices in liver cirrhosis using non-invasive parameters

Abstract

Aim: recent guidelines recommend that all cirrhotic patients without previous variceal hemorrhage undergo endoscopic screening to detect esophageal varices. The aim of this study is to evaluate clinical, laboratory and ultrasound parameters to detect esophageal varices.

Methods: this is a cross sectional study. Fourty seven consecutive cirrhotic patients without history of variceal hemorrhage underwent upper endoscopy. Physical examination, laboratory and ultrasonography to find portal vein diameter and anterioposterior splenic measurement of each patient were also recorded.

Results: esophageal varices was detected in 36 of the 47 patients (76.6%). Using bivariate analysis we found that a platelet count of 82,000/ul (90.9% sensitivity; 41.7% specificity), portal vein diameter of 1.15 cm (75% sensitivity; 54.5% pecificity) and an anteroposterior splenic measurement of 10.3 cm (83.3% sensitivity; 63.6% specificity) were predictive factors for esophageal varices in liver cirrhosis.

Conclusion: our data show that platelet count, portal vein diameter and anteroposterior splenic measurement can be used as non invasive parameters to detect esophageal varices in cirrhotic patients.