الفهرس 
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Abstract
Chronic liver disease (CLD) is an important cause of morbidity and mortality and represents a major health problem worldwide. Liver cirrhosis is the final common pathway of many cases of CLD.
Portal hypertension is a progressive, inevitable consequence of liver cirrhosis, which leads to formation of portosystemic collateral veins. Among them, esophageal varices have the greatest clinical impact because their rupure results in variceal heamorrhage that can be fatal. Upper gastrointestinal (GI) endoscopy is the gold standard in the diagnosis of esophageal varices.
Practice guidelines have recommended that, all patients with cirrhosis undergo screening upper GI endoscopy to detect esophageal varices at the time of diagnosis and after that, surveillance endoscopies should be performed every 2 to 3 years in cirrhotic patients without varices and the patients with small varices be endoscoped every 1 to 2 years and annually in the setting of decompensation
Therefore, the identification of non invasive methods that can accurately predict esophageal varices particularly large esophageal varices in cirrhotic patients and help to identify patients at greatest risk and thereby reduce the necessity of endoscopic screening are needed.
Transient elastography (TE, Fibroscan, Echosens, France) is a non invasive technique developed to assess hepatic fibrosis in patients with chronic liver disease and a good correlation between liver stiffness and portal hypertension (PHT) as well as, the presence of esophageal varices has been reported suggesting that, it could be an interesting tool for the non invasive evaluation of PHT and the presence and the size of esophageal varices.
This study aimed to measure liver stiffness by fibroscan to predict esophageal varices in patients with chronic liver diseases.
This study was carried out on 75 patients with chronic liver diseases attending to and admitted in Shebin Elkom fever hospital.
All patients included in this study were subjected to full history taking and thorough clinical examination, full laboratory investigations including: complete blood count, liver profile tests, kidney function tests, abdominal ultrasonography, upper GI endoscopy and liver stiffness measurement by fibroscan.
The patients were divided according to upper gastrointestinal endoscopy results into: 25 patients with no evidence of esophageal varices (group I), 50 patients with evidence of esophageal varices (group II), 38 patients of them had small OV (group IIa) and 12 patients had large OV (group IIb).
The present study found that,
There was statistically significant difference between patients without varices (group I) and those with varices (group II) regarding haemoglobin level, platelets count, INR, serum albumin, PV diameter, platelets Count / spleen diameter ratio and liver stiffness measurement by fibroscan.
There was statistically significant difference between patients with small varices (group IIa) and those with large varices (group IIb) regarding haemoglobin level, platelets count, INR, serum albumin, platelets count / spleen diameter ratio and liver stiffness measurement by fibroscan.
There was a high statistically significant increase in liver stiffness in patients with esophageal varices (group II) than patients without varices (group I), it was proved to be highly sensitive and adequately specific in differentiation between the two group. Also, it was highly sensitive in differentiation between patients with small varices (group IIa) and those with large varices ) group IIb).