الفهرس 
Hepatitis C virus infectionOnly 14 pages are availabe for public view
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Abstract
The development of esophageal varices is one of the major complications of portal hypertension, which is considered a main complication of liver cirrhosis.Variceal bleeding occurs in 20–40% of cirrhotic patients with esophageal varices and The use of endoscopic prophylactic band ligation and non-selective beta blockers can decrease the risk of esophageal bleeding by 50%, so the current guidelines recommend screening all liver cirrhosis patients by endoscopy.
Therefore, endoscopic screening of all patients with liver cirrhosis would result in a large number of unnecessary endoscopies and additional burden to endoscopic units and also repeated endoscopic examinations are unpleasant for the patients.
For these reasons, several studies have examined how to identify patients with varices using non-invasive or minimally invasive methods to avoid endoscopy in patients with a low risk of varices.
The aim of our study was to prospectively evaluate the possibility of using platelet count/spleen diameter ratio and the right liver lobe size/albumin ratio as noninvasive predictors of esophageal varices in patients with liver cirrhosis.
This prospective study included one hundred fifty patients with liver cirrhosis. All studied subjects underwent a detailed clinical examination, biochemical workup, upper gastrointestinal endoscopy and abdominal ultrasound. The platelet count/spleen diameter ratio and the right liver lobe/albumin ratio for all patients were calculated.
Plt count/spleen diameter ratio, plt count and spleen diameter demonstrated a high statistically significant correlation with the presence and grade of esophageal varices . as according to sensitivity and specificity test the most accurate screening test for diagnosis of esophageal varicose is PLT/SD ratio as AUC (87.4%), also it is a good negative test as specificity (86.7%) with cutoff value (1026.7), but for suspect a case most sensitive test is PLT count as sensitivity (93.3%) with cutoff value (120.5). these tests followed by spleen diameter with accuracy (78.2%), and the least test is right lobe/ albumin ratio which cannot depend on it in diagnosis of esophageal varices as its accuracy is (52.2%),sensitivity 66.7% and specificity 48.3%.