Non‐Invasive and Minimally Invasive Diagnosis of Varices

Franchis, Roberto de

doi:10.1002/9781444393989.ch4

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…Several studies have discussed how to identify patients with varices using non-invasive or minimally invasive methods [14] . The development of non-invasive methods for oesophageal varices prediction could reduce the use of upper gastrointestinal endoscopy in variceal screening and also provide an alternative way to confirm the results of conventional endoscopic diagnosis [15] .…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Non-Invasive Blood Ammonia Level for the Presence of Oesophageal Varices in Egyptian Patients With Liver Cirrhosis

Hafez

2015

Journal of Gastroenterology and Hepatology Research

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no statistical significant difference between the two groups (p=0.34). Ammonia level in group III was 73.37±30.36 µmol/L with no statistical significant difference with the other groups (p>0.05). In group I; ammonia level is positively correlated with the splenic vein diameter with r = 0.22 (p=0.026) but did not correlate with the grade of oesophageal varices r =0.031 (p-value=0.762). In multivariate analysis; ammonia combined with platelets, Age, PT and PC shared in a significant prediction model (I) for esophageal varices grading (p=0.002). Prediction model (II) including portal and splenic veins diameters and the liver size was developed (p=0.016). CONCLUSION: Non-invasive means could be used to monitor cirrhotic patients and consider treatment. Ammonia level can not be used alone but its use within a significant prediction model can help restricting the use of endoscopic screening in patients with a high probability of esophageal varices. INTRODUCTIONOesophageal varices due to portal hypertension are a major concern in cirrhotic patients because of the risk of bleeding [1] . ABSTRACT AIM: Although recent guidelines recommend screening of cirrhotic patients by upper endoscopy for oesophageal varices prediction, Non-invasive parameters are needed due to high endoscopy cost and burden on endoscopic units particularly in poor countries. The aim of this study is to evaluate the accuracy of using ammonia blood level as potential non-invasive predictor of oesophageal varices in cirrhotic patients. METHODS: This prospective study was conducted on 150 Egyptian participants. Patients were categorized as group I which included 100 with oesophageal varices and group II included 30 patients without varices. There were 20 healthy control participants served as a control group (group III). All patients underwent for full clinical and laboratory workup, abdominal ultrasound and upper gastrointestinal endoscopy. Venous ammonia blood levels were calculated for all the contributors of this study. RESULTS: The mean ammonia level was higher in group I (88.29±42.82 µmol/L) than in group II (82.77±49.76 µmol/L) with

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Section: Discussionmentioning

confidence: 99%

Predictive Value of Non-Invasive Blood Ammonia Level for the Presence of Oesophageal Varices in Egyptian Patients With Liver Cirrhosis

Hafez

2015

Journal of Gastroenterology and Hepatology Research

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“…In addition, patients with varices should avoid aspirin, non-steroidal anti-inflammatory drugs, and other anticoagulants to reduce the risk of gastrointestinal bleeding. Although upper endoscopy is the “gold standard” for diagnosing varices, the cost, risk, and inconvenience associated with this invasive procedure have led many to seek alternative means to predict the presence and severity of varices (2, 3). Development of reliable and simple non-invasive tests that accurately predict the presence of varices could greatly improve the clinical care of the increasing number of patients with chronic liver disease.…”

Section: Introductionmentioning

confidence: 99%

Factors That Determine the Development and Progression of Gastroesophageal Varices in Patients With Chronic Hepatitis C

et al. 2010

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“…, observed that portal vein size had significant diagnostic value and patients with mean portal vein size of 1.5cm were at high risk of bleeding [10]. Baik et al, [11] and Franchis et al, [12,13] have proposed ultrasonography for primary prevention as well as for prediction of recurrent variceal bleeding. Schepis et al, in their logistic regression study found that the portal vein diameter >13mm was an independent risk factors for the presence of varices [14].…”

Section: Discussionmentioning

confidence: 99%

Portal Vein Diameter by Ultrasonography as a non-Invasive Predictor of Esophageal Varices.

Basnet

Thapa

Sapkota³

et al. 2017

IJMBioS

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Esophageal varices are one of the most serious consequence of portal hypertension in patients with liver diseases If undetected or left untreated, it can result in massive upper gastrointestinal bleed and can be fatal. Therefore, a timely detection and management of the varices in cirrhotic patient is a must. Several studies have evaluated possible noninvasive markers of esophageal varices to reduce the number of unnecessary endoscopies in patients with cirrhosis but without varices. Endoscopic surveillance of esophageal varices in patients with liver cirrhosis is expensive for the health system and uncomfortable for the patients. Recently, non-invasive ultrasound-based parameters seem to offer valuable information about the status of esophageal varices and thus challenge the need for repetitive endoscopic monitoring. In this study, our aim was to develop a predictive model using an independent risk factor for the presence of varices in the enrolled patients. This is a cross-sectional study. The study analyzed 50 patients with liver diseases from February 2014 to January 2015. All the patients with cirrhosis of either gender except those with hepatocellular carcinoma and previous surgical or medical intervention for portal hypertension were enrolled in the study. Ultrasound of the abdomen was done in all cases to note the portal vein diameter. The varices visualized were graded endoscopically. Data entry was done in SPSS version 20 and statistical analysis was done with Chi Square test. Total 50 patients were enrolled in the test. Varices was present in 47 (96%) of the patients. Small varices were present in 13 (26%) and large varices was present in 34 (68%) of patients. For the patients with small varices, the mean portal vein diameter was 13.23 mm and for those with large varices, the mean portal vein diameter was 16.83 mm. The above results signify that the presence of varices was associated with the mean portal vein diameter of 13.23 mm or more and the result was statistically significant with the p value of 0.024 Measurement of portal vein diameter by ultrasonography can be used as a non-invasive predictive indicator of the development of gastro- esophageal varices in patients with portal hypertension.

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Non‐Invasive and Minimally Invasive Diagnosis of Varices

Cited by 5 publications

References 31 publications

Predictive Value of Non-Invasive Blood Ammonia Level for the Presence of Oesophageal Varices in Egyptian Patients With Liver Cirrhosis

Predictive Value of Non-Invasive Blood Ammonia Level for the Presence of Oesophageal Varices in Egyptian Patients With Liver Cirrhosis

Factors That Determine the Development and Progression of Gastroesophageal Varices in Patients With Chronic Hepatitis C

Portal Vein Diameter by Ultrasonography as a non-Invasive Predictor of Esophageal Varices.

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