International Journal of Current Microbiology and Applied Sciences (IJCMAS)
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Original Research Articles                      Volume : 5, Issue:5, May, 2016

PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
Publisher : Excellent Publishers
Email : /
Editor-in-chief: Dr.M.Prakash
Index Copernicus ICV 2018: 95.39
NAAS RATING 2020: 5.38

Int.J.Curr.Microbiol.App.Sci.2016.5(5): 701-715

Non Invasive Diagnosis of Esophageal Varices: Can it Replace
Screening Endoscopy?
Elshazly Abd Elhady Sheta1, Mohamed Yousef 1, Sherief Abd-Elsalam1*,Rania Essam Eldeen Mohamed2, Ayat Ismail1, Ferial El-Kalla1, Loai Mansour1, Abdelrahman Kobtan1, Mohamed Elhendawy1 and Hala M. Elsabagh4
1Tropical Medicine & Infectious Diseases Department, Tanta University, Egypt
2Radiology Department, Tanta University, Egypt
3Tropical Medicine & Infectious Diseases Department, Kafr Elsheikh University, Egypt
4Public health and community medicine Department, Tanta University Faculty of Medicine, Tanta, Egypt
*Corresponding author

This study recommended that all cirrhotic patients should be screened for presence of esophageal varices (OV). In developing countries, Endoscopy screening of all cirrhotic patients is a large burden and patients’ compliance decreases gradually.  The aim of this study was to evaluate right lobe diameter of the liver /serum albumin ratio and other parameters as platelet count /spleen diameter, portal vein velocity and hepatic artery resistive index for accurate non-invasive prediction of esophageal varices (OV).  100 cirrhotic patients were enrolled in the study. All patients were subjected to full history taking, thorough clinical examination, complete blood picture, complete liver functions, prothrombin time &activity, ultrasound on abdomen &pelvis, doppler US and upper endoscopy. Right lobe diameter of the liver /serum albumin at a cutoff value≥4.92significantly predicted presence of OV with 63.61%sensitivity, 97.67%specificity, PPV 97.3%, and a NPV 66.7%. A platelet count /bipolar spleen diameter cutoff value<570 significantly predicted presence of OV with 77.19%sensitivity, 93.02%specificity, a PPV of 93.6%, and a 75.5% NPV. Portal vein velocity could significantly predict OV at a cutoff value≤12cm/sec with 85.96% sensitivity, specificity 86.05% PPV 89.1%, and NPV 82.2. Hepatic artery resistive index was also significantly predictive for OV presence with 70.18%sensitivity, 100% specificity, 100%PPV and a 71.7% NPV at a cutoff value>0.76.  Right liver lobe diameter /serum albumin, platelet count /spleen diameter and the Doppler US parameters; portal vein velocity and hepatic artery resistive index are easy to perform, inexpensive and can predict the presence of esophageal varices.

Keywords: esophageal varices,non-invasive diagnosis,Right liver lobediameter/
serum albumin, plateletcount/spleen diameter, Doppler US.

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How to cite this article:

Elshazly Abd Elhady Sheta, Mohamed Yousef , Sherief Abd-Elsalam, Rania Essam Eldeen Mohamed, Ayat Ismail, Ferial El-Kalla, Loai Mansour, Abdelrahman Kobtan, Mohamed Elhendawy and Hala M. Elsabagh. Non Invasive Diagnosis of Esophageal Varices: Can it Replace Screening Endoscopy?Int.J.Curr.Microbiol.App.Sci. 5(5): 701-715. doi:
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