الفهرس 
Esophageal VaricesOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) is a major cause of chronic liver disease infecting more than 170 million people worldwide. HCV produces a wide gamut of manifestations varying from mild self-limiting disease to cirrhosis and hepatocellular carcinoma
Esophageal varices development is among the major complications of liver cirrhosis, with an estimated prevalence of approximately 50%. The risk of bleeding from varices is 25%-35% with majority of the initial bleeding occurring within 1 year from varices detection. The mortality from each episode of variceal bleeding is 17%-57%.
The incidence of bleeding can be reduced with nonselective beta-blockers. It is also suggested that prophylactic endoscopic variceal ligation can decrease the incidence of first variceal bleeding and mortality in patients with liver cirrhosis who have large varices. Therefore, annual endoscopic screening is highly recommended for patients with small esophageal varices while the procedure should be conducted once every two years for patients suffering from liver cirrhosis without diagnosed varices.
Nevertheless, repeated endoscopic examinations are unpleasant for patients, and have cost impact on health care insurance, while only half of cirrhotic patients have esophageal varices, and up to 30% have large varices.
As a consequence, several non-invasive tools have been evaluated as an alternatives to endoscopy, to avoid unnecessary endoscopy in low-risk patients, and to identify noninvasive factors that may predict the presence and size of esophageal varices, and risk prediction for bleeding. To date, several predictive markers of the presence of varices in patients with liver cirrhosis including clinical, laboratory, and hepatic echographic data have been published. The right liver lobe diameter/albumin was evaluated as a noninvasive parameter to determine the presence of OVs in patients with liver cirrhosis.
The aim of study was to investigate the value of measurement of (Rt. lobe diameter/ serum albumin ratio) in the prediction of esophageal varices.
This was Case- control study, was carried out at outpatient clinics of Hepatology and inpatient department of Gastroenterology at Ain Shams University Hospital on 100 patients divided into 3 groups: (group 1): 30 patients with Child-Pugh A, (group 2): 30 patients with Child-Pugh , (group 3): 40 patients with Child-Pugh C, during a period of 6 months.
The main results of the study revealed that:
There was insignificant difference between both groups as regard age or sex.
There were highly significant difference between both groups as regard Total-Bilirubin, Direct Bilirubin, Serum albumin, INR and Alpha feto-protein.
There were highly significant difference between both groups as regard WBCs, RBCs and Platelet.
There were highly significant difference between both groups as regard Platelet count /spleen diameter ratio and Right liver lobe size/Serum Albumin ratio.
There were 20% with Grade I varices, 26.67% with Grade II varices, 30% with Grade III varices, 23.33% with Grade IV varices.
There were significant correlation between Right lobe of Liver/Albumin ratio and Platelet count/Spleen diameter ratio.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.