الفهرس 
Aim of the Study
Portal HypertensionOnly 14 pages are availabe for public view
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Abstract
irrhosis is the end stage of chronic damage to the liver. Portal hypertension commonly
accompanies liver cirrhosis with the development of OV and PHG as major
comolications.
Gastrooesophgeal variceal hemorrhage (GOV) is a major complication of portal hypertension resulting
from liver cirrhosis. Oesophageal variceal bleeding is one of the most dreaded complications of
cirrhosis because of its high mortality. The prevalence of varices in patients with
cirrhosis is approximately 60-80%. The incidence of OV increases by nearly 5% per year, and
the rate of progression from small to large varices is approximately 5 to 10 % per year.
The mortality rate from variceal bleeding is about 17-
57 % but when patients are treated optimally in hospital it is found to be only 20%.
The American Association for the Study of Liver Disease and the Baveno V Consensus
Conference on portal hypertension recommended that all cirrhotic patients should be
screened for the presence of OV when liver cirrhosis is diagnosed.
Some authors have suggested repeating endoscopy at 2-3 year intervals in patients without varices
and at 1-2 year intervals in patients with small varices so as to evaluate the development or
progression of the OV. However, this approach
has two major limitations. Endoscopy is an invasive procedure and secondly the cost effectiveness
of this approach is also questionable. As only 9-36% patients with cirrhosis are found to have
varices on screening endoscopy. It may be more cost- effective to routinely screen patients at
high risk for the presence of varices so as to reduce the increasing burden and procedure cost
of endoscopy units.
Identification of non-invasive predictors of OV and portal gastropathy will enable us to
carry out UGE in selected group of patients thus avoiding unnecessary intervention and at the same
time not missing the patients at risk of bleeding
The aim of this work is to assess the value of MELD score as a non-invasive predictor of OV in
comparison to other predictors.
The current cross-sectional study was conducted on one hundred cases who presented with established
liver cirrhosis of any cause the history, clinical examination, laboratory investigations,
ultrasound examination and UGE was done for all cases, Child-Pugh score and MELD score were
calculated from parameters obtained at time of admission.
Our patients were classified into 2 groups:
Group I: 75 Patients were found to have OV by UGE.
Group II: 25 Patients hade no OV by UGE.
This study revealed that Baseline MELD score as well as Child-Pugh score and other predictors as
platelet count were significantly higher among patients with OV than those without OV.
In multivariate analysis , the present study showed that patients with MELD score ≥11 or platelet
count ≥ 142.5 had a higher incidence of presence of OV.
It is found that MELD score is more accurate than CTP and other non-invasive predictors such as
platelet count in predicting presence of OV in patients with liver cirrhosis.