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1. Eur J Intern Med. 2012 Apr;23(3):267-72. Epub 2011 Dec 10.

Can we consider the right hepatic lobe size/albumin ratio a noninvasive predictor
of oesophageal varices in hepatitis C virus-related liver cirrhotic Egyptian
patients?

Esmat S, Omarn D, Rashid L.

Department of Internal Medicine, Faculty of Medicine, Cairo University, Egypt.

BACKGROUND: The current guidelines recommend the screening of all cirrhotic
patients by endoscopy, but repeated endoscopic examinations are unpleasant for
patients and have a high cost impact and burden on endoscopic units. The aim of
this study is to evaluate the optimal liver lobe size/albumin ratio and to
compare this ratio with spleen size, platelet count and platelet count/spleen
diameter ratio as potential noninvasive predictors of oesophageal varices in
hepatitis C virus (HCV)-related liver cirrhosis in Egyptian patients.
METHODS: This prospective study included one hundred patients with HCV-related
liver cirrhosis. All studied subjects underwent a detailed clinical examination,
biochemical workup, upper gastrointestinal endoscopy and abdominal ultrasound.
The platelet count/spleen diameter ratio and the right liver lobe/albumin
concentration ratio for all patients were calculated.
RESULTS: The 4 predictors demonstrated a high statistically significant
correlation with the presence and grade of oesophageal varices (P values<0.001).
The platelet count/spleen diameter ratio had the highest accuracy, followed by
the right liver lobe/albumin concentration ratio, spleen size and then platelet
count.
CONCLUSION: The use of the studied noninvasive predictors, especially the
platelet count/spleen diameter ratio and the right liver lobe/albumin
concentration ratio, can help physicians by restricting the use of endoscopic
screening only to patients presenting a high probability of oesophageal varices.
This is especially useful in clinical settings where resources are limited and
endoscopic facilities are not present in all areas. Such is the case in Egypt,
where there is a large number of patients who require oesophageal screening for
oesophageal varices.

Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier
B.V. All rights reserved.

PMID: 22385886 [PubMed - in process]