Non-endoscopic prediction of presence of esophageal varices in cirrhosis

Abstract

Objective: To identify hematological, biochemical and ultrasonographic predictors of esophageal varices in patients of cirrhosis.

Design: Cross-sectional, analytical study.

Place and duration of study: Department of Gastroenterology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from September 2003 to March 2004.

Patients and methods: One hundred and one patients with established cirrhosis and no history of variceal bleed underwent physical examination, hematological, biochemical tests and abdominal ultrasound examination. Esophagogastroduodenoscopy (EGD) was carried out in all patients. Presence of varices on EGD was correlated with hematological, biochemical and ultrasonographic variables by regression analysis.

Results: Esophageal varices were seen in 65 patients while 36 patients had no varices. High grade varices were seen in 15 patients and 50 patients had low grade varices. Serum albumin less than 2.95 g/dl, platelet count less than 88 x 103/muL and portal vein diameter more than 11 mm were associated with presence of varices. High grade varices were predicted by serum albumin < 2.95 g/dl and portal vein diameter more than 11 mm.

Conclusion: Patients with serum albumin < 2.95 g/dl, platelet count < 88 x 103/muL and portal vein diameter > 11 mm are more likely to have high grade varices. These patients are candidates for surveillance endoscopy.