Essay On Esophageal Varices

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Currently endoscopy has been the gold standard modality in identifying esophageal varices 108[13]. However, many studies have identified many noninvasive markers predicting the presence and grading of esophageal varices 109,110[14,15]. Many studies have revealed that multiple factors can be used in prediction of the presence of esophageal varices like splenomegaly, 111-113[16-18] spider nevi, ascites114[19]Child Turcotte Pugh grading system113,114[18,19] platelet count 114-118[19-23] portal vein diameter, prothrombin time119[24], platelet count: spleen diameter ratio 119,120[24,25], serum bilirubin 114[19], and serum albumin. Esophageal varix (EV) is the result of spontaneous formation of collateral vessels between esophageal veins and …show more content…

The serum markers (platelet count, APRI score, Forn’s score, Lok score, FIB-4, Transient Elastography [TE]) were compared with percutaneous liver biopsy (LB) to predict the extent of disease. All the evaluated tests had outstanding predictive value (AUROCs 0.839-0.979). 124[29] In our study, liver biopsy and elastography were not taken as variables, but portal vein size; an indirect evidence of portal hypertension (due to liver fibrosis) was compared with serum markers. In a study reported by Sudha Rani et al (2015) measurement of PVD (> 13 mm) and ultrasound findings were independent non-invasive predictors for presence of esophageal varices in patients with chronic liver disease with portal hypertension 125[29] Either large varices or small varices or both with the Red signs are globally known as Varices Needing Treatment (VNT). In another study conducted in 2016, Xiao G et al [30] studied two markers i.e. APRI and FIB-4 on 2176 patients to correlate with liver fibrosis. However these two models had very low accuracy in predicting HBV-related liver fibrosis in HCC patients suggesting that liver fibrosis alone may not be the sole factor to influence these markers. In our study, we did not study this variate of HCC presence of which could

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