الفهرس 
Esophageal varicesOnly 14 pages are availabe for public view
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Abstract
The aim of our study was to evaluate the accuracy of liver stiffness measurements performed using transient elastography as a non-invasive tool for prediction of the presence and the size of esophageal varices in patients with HCV- related chronic liver disease.
This cross sectional analytic study included sixty patients with HCV- related chronic liver disease patients who fulfilled inclusion criteria. All patients were subjected to full history taking, full clinical examination, laboratory investigations, abdominal ultrasonography, diagnostic upper GIT endoscopy and Liver stiffness measurements (LSM) using Fibroscan.
According to presence of esophageal varices, patients were divided into two groups:
group I: Patients with no esophageal varices (19 patients).
group II: Patients with esophageal varices (41 patients).
group II were further subdivided into two subgroups:
group (II a): Patients with small varices (12 patients).
group (II b): Patients with medium and large varices (29 patients).
As regard demographic data, the results revealed that number of male patients in group II was more than that of group I, similarly, patients coming from rural areas were more in group II than group I.
Regarding clinical examination, there was a high statistically significant difference between both groups as regard detection of papable spleen which was more in group II than in group I.
On comparising the laboratory findings, we found that platelet count was lower in group II than in group I, and also, it was lower in group IIb than group IIa.
Regarding ultrasound findings, there was a highly significant difference in spleen diameter and portal vein diameter between the groups, where it was larger in group II than group I, and also in group IIb than group IIa.
Regarding liver stiffness measurements as a predictor for the presence of esophageal varices, the results of our study showed that transient elastography was a useful technique for predicting presence of esophageal varices, with the best cutoff value >20 Kpa with a sensitivity of 97.56% and a specificity of 94.74%, while the best cutoff value in detection of medium and large esophageal varices was > 35 Kpa with a sensitivity of 75.86% and a specificity of 100%.
Regarding platelet count/spleen diameter ratio in our study, the best cutoff value for diagnosis of presence esophageal varices was ≤ 800 with a sensitivity of 95.1% and a specificity of 78.9 %, while the best cutoff value in detection of medium and large esophageal varices was ≤ 588.23 with a sensitivity of 65.5% and a specificity of 100%.