Introduction Screening for varices with two yearly gastroscopy is recommended practise for all patients with liver cirrhosis. Prevalence of oesophageal or gastric varices in patients with liver cirrhosis varies in the literature from 30–70%.
The Aim of this study was to analyse if the result of transient elastography (TE) can be used to predict the risk of developing gastric and/or oeosphageal varices in cirrhotic patients. We compared this data with endoscopic and radiological evidence of portal hypertension.
Methods We analysed data of 807 patients who underwent TE examination at East Cheshire NHS Trust and identified 103 patients with suspected liver cirrhosis (liver stiffness score of >12.5 kPa). The cut off F4 liver fibrosis/cirrhosis varies between 14.5 kPa to 18.2 kPa for different aetiologies of liver cirrhosis. We evaluated results of TE against upper GI endoscopy and abdominal ultrasound/CT.
Results 26% of patients with F4 liver fibrosis/cirrhosis were found to have oesophageal/gastric varices at endoscopy. A total of 37% patients had evidence of portal hypertension on USS or CT. Only 41% of patients with splenomegaly were found to have oesophageal/gastric varices. 78% of those found to have varices had a liver stiffness score of >25 KPa.
Conclusion We postulate that TE helps us to stratify a patient’s risk of developing oesophageal/gastric varices, according to their liver stiffness score. The likelihood of developing oesophageal/gastric varcies increases with increased liver stiffness. Patients with liver stiffness scores lower than 25kPa may avoid unnecessary upper GI endoscopy.
Disclosure of Interest None Declared
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