ESOPHAGEAL VARICES;

Abstract

Bleeding from esophageal varices is associated with high morbidity and mortality. It is currently recommended that allpatients with liver cirrhosis undergo upper gastrointestinal endoscopy to identify those who have esophageal varices. This approachleads to unnecessary endoscopies. There is need to evaluate clinical, laboratory and imaging parameters that may predict the presence ofesophageal varices and help select patients for endoscopy. Objective: Identify hematological, biochemical and ultasonographicpredictors of oesophageal varices in patients of cirrhosis. Study design: Cross sectional Descriptive study. Setting: Department ofGeneral 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 patientswho had portal vein diameter of >20mm 41% had evidence of esophageal varices. Splenic measurement of >13cm was associated withmaximum number of cases of esophageal varices i.e 82%. Conclusion: It is concluded from the study that male gender, clinically palpablespleen, low platelet count, portal vein diameter and splenic measurement can be used as non invasive parameters to predict esophagealvarices reducing the need of unnecessary endoscopies.