LIVER STIFFNESS MEASURMENT BY FIBROSCAN FOR PREDICTING THE GRADES OF OESOPHAGEAL VARICES IN HCV CIRRHOTIC PATIENTS

Document Type : Original Article

Authors

1 Internal Medicine Department Ain Shams University Hospitals

2 Institute of Environmental Studies and Research Ain Shams University.

3 Internal Medicine Department, Faculty of Medicine, Ain Shams University.

Abstract

Introduction: oesophageal varices is one of the most common and life threatening complications of liver cirrhosis. the need for use of non invasive modalities for its prediction rather than endoscopy is important to decrease burdens and increase patient compliance .
Aim: to predict oesophageal varices presence by fibroscan and possible grading by degree of liver stiffness in Hepatitis C Virus related cirrhotic patients.
Methods: the study was carried out on 150 patients with HCV related liver cirrhosis attending Ministry of Health outpatient clinics and hospitals after being writtenly consented that they agreed to participate in this study
All patients were subjected to full history taking & thorough clinical examination, full laboratory investigations include complete blood picture, liver profile tests , kidney function tests, abdominal ultrasound , liver stiffness measurement by fibroscan and upper GIT endoscopy.
The patients were divided according to upper GIT endoscopy results into three groups. Group 1: included 50 patients with liver cirrhosis and without oesophageal varices. Group 2: included 50 patients with liver cirrhosis and small oesophageal varices (Grade I&II).  Group 3: included 50 patients with liver cirrhosis and large esophageal varices (Grade III & IV).
Results: there was a statistically significant increase in liver stiffness, INR , total bilirubin, ammonia level and spleen size  among patients with ov than those without and among those with large varices than those with small varices , while there was a statistically significant decrease in the level of Hb level , platelet count and serum albumin level among patients with varices than those without and among patients with large varices than those with small varices.
Conclusion: liver stiffness measurement byTransient Elastography could be used as a valuable non-invasive screening tool for the prediction of the presence and size of oesophageal varices in HCV cirrhotic patients.
Key words: Oesophageal varices; Fibroscan; Grading; Non-invasive methods
 

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