Abstract
Background and aim of the work: Gastric varices (GV) are an ominous complication of portal hypertension (PH). The prediction of GV is a mandatory request to avoid their risky bleeding. This work aimed at evaluating the value of Serum- Ascitic Albumin Gradient (SAAG) in prediction of the presence and severity of GV in cirrhotic ascitic patients. Patients and methods: A descriptive cross-sectional study was conducted on 75 cirrhotic ascitic patients. All participants were subjected to full history taking, thorough clinical examination and laboratory investigations including liver function tests, complete blood count, kidney function tests and hepatitis markers including anti hepatitis C virus antibody (HCV-Abs) and hepatitis B surface antigen (HBs-Ag). Abdominal ultrasonography and abdominal diagnostic paracentesis with calculation of SAAG were also done. Patients were also subjected to upper gastrointestinal (GI) endoscopy and they were divided into two main groups according to the presence or absence of GV. Patients with GV were further classified into three groups depending on the form and size of GV. Results: SAAG - at a cut off value ≥ 2.4 gm/dl - predicted the presence of gastric varices with 93.28 % specificity, 59.92 %positive predicting value, 66.67% sensitivity and 96.5% negative predicting value. SAAG value also showed a highly significant increase with the progression of grades of GV. Conclusion: Serum- ascites albumin gradient (SAAG) could be considered as an efficient non-invasive predictor for the presence of GV and could reflect the severity of G.V in cirrhotic ascitic patients.
Highlights
Liver cirrhosis with the eventual portal hypertension (PH) are the most critical result of chronic liver diseases
This work aims at evaluating the value of SerumAscitic Albumin Gradient (SAAG) in prediction of the presence and severity of gastric varices (GV) in cirrhotic e- Prothrombin time (PT) and International Normalized Ratio (INR)
ROC curve showed that Serum- ascites albumin gradient (SAAG) at a cut off value ≥ 2.4gm/dl could predict the presence of gastric varices with 93.28 % specificity, 59.92 % positive predicting value, 66.67% sensitivity and 96.5% negative predicting value
Summary
Liver cirrhosis with the eventual portal hypertension (PH) are the most critical result of chronic liver diseases. GV represent an important finding in about 20% of cirrhotic patients with portal hypertension [2]. It is more related to the size and wall tension of the varix than to the degree of PH [3]. Risk factors for bleeding GV are mainly the degree of severity of liver disease, size, location and the presence of red spots on the varix [4,5,6]. Gastric varices (GV) are an ominous complication of portal hypertension (PH). This work aimed at evaluating the value of Serum- Ascitic Albumin Gradient (SAAG) in prediction of the presence and severity of GV in cirrhotic ascitic patients
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