Νon-Invasive Assessment of Esophageal Varices in Patients with Liver Cirrhosis

Abstract

Background: Esophageal variceal related bleeding is a lethal outcome of portal hypertension in patients with cirrhosis with mortality. Objective: To assess esophageal varices in patients with liver cirrhosis using non-invasive parameters. Study Design: Cross sectional study. Settings: Gastroenterology Department, Lahore General Hospital, Lahore Pakistan. Duration: 6 months from September 2016 to February 2017. Methodology: Data of all cirrhotic patients admitted in medical ward was collected.  Liver cirrhosis was confirmed by abdominal ultrasound. Values of platelet count, serum albumin and serum ALT estimated by automated biochemistry analyzer. Serum ALT / platelet ratio index was measured by formula. Results: It is observed that esophageal varices are most common in middle to old age. 53.9 % of the cirrhosis patients of the age greater than 40 years have esophageal varices.  Mean age of patients with esophageal varices (EV) was 40.94 year. Average duration of cirrhosis was 3.09 years and level of serum alanine aminotransferase (ALT) was raised with thrombocytopenia and low serum albumin. Aspartate aminotransferase / platelet ratio (APRI) index was raised as compared to patients without esophageal varices. Conclusion: Esophageal varices are most common in middle to old age and non-invasive assessment including level of serum alanine aminotransferase, aspartate aminotransferase, serum albumin, platelet count and APRI ratio may help to assess esophageal varices in patients with liver cirrhosis.