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Abstract
The current guidelines recommend the screening of all cirrhotic patients by endoscopy, but repeated endoscopic examinations are unpleasant for patients and have a high cost impact and burden on endoscopic units. The aim of this study is to evaluate the accuracy of using ammonia blood level as potential noninvasive predictor of esophageal varices in cirrhotic patients. Methods:This prospective study included one hundred fifty subjects. All studied subjects underwent a detailed clinical examination, biochemical workup, upper gastrointestinal endoscopy and abdominal ultrasound. Ammonia blood levels for all patients were calculated. Results: Ammonia demonstrated a high statistically significant correlation with the presence and grade of esophageal varices if it is put in a prediction model but ammonia alone we cannot depend on it in diagnosis of esophageal varices