Abstract
BackgroundThe prevention of portal hypertensive complications, including upper gastrointestinal bleeding, is critically important and achieved only through the use of upper endoscopy for the management of oesophageal gastric varices (EGVs). There is a paucity of data and limited utilization of non-invasive predictive parameters to guide the selection of patients who may benefit from endoscopic surveillance, especially in cirrhotic patients with coexistent portal vein thrombosis.ResultsThe study was conducted in eight hospitals in the western region of Saudi Arabia over the period of 2015–2017. Among 1349 chronic liver disease patients, eighty-five patients with complete endoscopic findings were included in the study. Twenty-eight patients were diagnosed with non-malignant PVT. Twenty-five patients (89%) developed oesophageal varices, compared with 57 patients with cirrhosis without PVT. A predictive factor for the development of oesophageal varices of statistical significance was hypoalbuminemia in PVT patients (p=0.04). No statistically significant differences were found in other biochemical markers (p<0.05) between the PVT and non-PVT groups.ConclusionsThe prevalence of oesophageal varices is increased in PVT patients. Serum albumin can be utilized as a predictor of varices development in cirrhosis patients.
Highlights
The prevention of portal hypertensive complications, including upper gastrointestinal bleeding, is critically important and achieved only through the use of upper endoscopy for the management of oesophageal gastric varices (EGVs)
The aim of our study was to evaluate possible non-invasive patient-related factors that would be helpful in predicting the finding of portal hypertensive gastroesophageal varices on upper endoscopy in cirrhotic patients with portal vein thrombosis (PVT) compared with cirrhotic patients without PVT who may benefit from early surveillance for detection and primary prophylaxis in a cohort of patients in the western region of Saudi Arabia
Of the 85 patients with cirrhosis who met the study’s inclusion criteria, endoscopic findings were available in twenty-eight cirrhotic patients with portal vein thrombosis and 57 patients with non-portal vein thrombosis
Summary
The prevention of portal hypertensive complications, including upper gastrointestinal bleeding, is critically important and achieved only through the use of upper endoscopy for the management of oesophageal gastric varices (EGVs). Predictors of the first bleeding episode in cirrhosis, in addition to the advanced stage of liver disease and advanced high-risk features of bleeding on varices [8], are coexistent bacterial infections, especially spontaneous bacterial peritonitis [9]. The risk has to be prevented by early detection of high-risk gastroesophageal varices that are precisely and accurately staged and managed through the performance of upper endoscopy. The aim of our study was to evaluate possible non-invasive patient-related factors that would be helpful in predicting the finding of portal hypertensive gastroesophageal varices on upper endoscopy in cirrhotic patients with PVT compared with cirrhotic patients without PVT (control group) who may benefit from early surveillance for detection and primary prophylaxis in a cohort of patients in the western region of Saudi Arabia
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