Analysis of Diagnostic Ability of Non – Invasive Parameters to Detect Esophageal Varices in Comparison with Endoscopy in Cirrhosis of Liver with Portal Hypertension

Abstract

Introduction: Portal hypertension is a frequent complication of liver cirrhosis and also a significant cause of mortality. It leads to the development of esophageal varices, in about 50% of cirrhotic patients. Screening is crucial, with endoscopy performed every 2-3 years. Non-invasive methods can identify patients at higher risk of bleeding. The study assesses clinical, biochemical, and imaging parameters for predicting esophageal varices.

Aim: The study aims to assess the effectiveness of clinical, biochemical, and imaging parameters in predicting esophageal varices.

Materials and methods: It is cross sectional observational study conducted in the Department General Medicine, at tertiary care hospital in South India, over a period of 1.5 years. Study population 38 patients.

Result: The sensitivity of PC/SD ratio of <1242 and CTP grade B/C in predicting the presence of esophageal varices was 100% with their positive predictive value were 100%  and 96.96% respectively.  The Portal vein diameter with cut-off of >12.5mm had a sensitivity of 78.1% and a positive predictive value (PPV) of 58.3%.

Conclusion: Upper gastrointestinal endoscopy is the gold standard for diagnosing esophageal varices in cirrhotic patients, but its limitations include invasiveness and poor availability. Non-endoscopic parameters like platelet count, portal vein diameter, PC/SD ratio, and Child Pugh grade may provide good diagnostic accuracy. A comprehensive multi-centric study is needed to confirm these findings.