Non-Invasive Assessment of Esophageal Varices in Cirrhotic Yemeni Patients

Objectives: To study the effectiveness of 6 non-invasive methods in the evaluation of the presence of esophageal varices in chronic liver disease (CLD) in Yemeni patients. Design: Prospective study of patients with chronic liver disease evaluated for presence or absence of esophageal varices by using non-invasive tests. Setting: Specialized center of gastrointestinal and liver diseases in Ibb city, Yemen. Subjects: Consecutive patients with clinical and paraclinical criteria of CLD with no upper GIT bleeding at presentation or in their past history were included in this study during the period from July 2017 to December 2017. Results: During the study period, 103 patients with CLD fulfilled the including criteria and were enrolled in this study, 60 of them were males and 43 were females. The age ranged between 16 years and 81 years and the mean age was 42.69 +/- 16.96 years. Of these 103 patients, 62 cases (59.95%) had esophageal varices, 36 (58%) were small and 26 (42%) were large. The sensitivity, specificity, PPV, and NPV of 6 studied para-clinical and biochemical variables were evaluated. The sensitivity and the specificity for spleen diameter was 79.7% and 33.3% respectively, for platelet count 26.6% and 87.2%, for P.V diameter 39% and 47.4%, for Rt. lobe diameter/albumin ratio 23.4% and 82%, for spleen diameter/platelet count ratio 37.5% and 74.4% and for AST/ALT ratio 53.1% and 51.3%. Conclusion: No one of the studied non-invasive tests had high predictive value or high sensitivity or specificity for prediction of esophageal varices, consequently upper GIT endoscopy is still the gold standard way in the diagnosis and grading of esophageal varices.