Hemodynamic Changes of Hepatic Veins as Predictors of Large Oesophageal Varices in Liver Cirrhotic Patients

Document Type : Original Article

Authors

1 Tropical Medicine Departments, Faculty of Medicine, Zagazig University, Zagazig, Egypt

2 General Surgery Department, Faculty of Medicine, Zagazig University, Egypt

3 Radiology Department, Faculty of Medicine, Zagazig University, Egypt.

Abstract

 
Background and study aim: Oesophageal varices (OV) are morbid and mortal complications of portal hypertension. Oesophago-gastroduodenoscopy (OGD) is the main diagnostic yet semi- invasive tool; different non-invasive methods were developed for early prediction and assessment of OV yet not fully evaluated. This work aims at assessment of changes of hepatic venous wave patterns as early predictors of large OV in cirrhotic patients without history of variceal bleeding.
Patients and methods: A number of 50 previously diagnosed liver cirrhotic patients were subjected to detailed history taking. After exclusion criteria only 46 patients were included in the study. They were subjected to routine investigations, OGD, abdominal ultrasound (US) and Color Doppler studying of the hepatic veins (HV).
Results : Out of the total number (46 liver cirrhotic patients included in the study), the triphasic waves were detected in (26.1%), biphasic waves in (43.5%) and monophasic waves in (30.4 %). Small varices were detected in (65.2 %), while large varices were detected in (34.8 %).The sensitivity of loss of the triphasic waveform in detecting large varices was high (93.8 %), specificity was (36.7 %), the positive predictive value was (44.1 %) and the negative predictive value was high (91.7 %).
Conclusion : The loss of hepatic venous triphasic waveform - detected by Color Doppler Abdominal Ultrasound Study- is a weak predictor of large OV in liver cirrhotic patients without history of variceal bleeding

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