Muhammad Iltaf, Waheedullah, Muhammad Abdullah Jan, Muhammad Daud.
Frequency of Esophageal Varices in Cirrhotic Patients with Ascites having no Upper Gastrointestinal Bleeding.
Ophthalmol Update Jan ;13(3):212-6.

Objective: To determine the frequency of esophageal varices in cirrhotic patients with ascites with no upper gastrointestinal bleeding. Esophageal varices are a direct consequence of portal hypertension that in cirrhosis results from both increased resistance to portal flow and increased portal venous blood inflow. Screening esophago-gastroduodenoscopy (EGD) for the diagnosis of esophageal and gastric varices is recommended when the diagnosis of cirrhosis is made particularly in those with decompensated status. Study design: Descriptive case series. Duration: The duration of study was six months after approval of synopsis. Settings: Department of Gastroenterology and Hepatology Hayatabad Medical Complex Peshawar. Material & Methods: This study was conducted at Gastroenterology and Hepatology Department, Hayatabad Medical Complex, Peshawar. Duration of study was 6 months in which a total of 196 patients were observed while keeping 85%1 proportion of esophageal varices among patients with liver cirrhosis with ascites (child pugh class C), 95% confidence interval and 5% margin of error using WHO sample size calculations. More over this was a cross-sectional study in which a consecutive (non-probability) sampling technique was used. Results: In this study mean age was 52 years with standard deviation ± 1.26. Forty eight percent patients were male 52% patients were female. Esophageal varices were found in 85% patients while 15% patients didn?t had esophageal varices. Conclusion: Gastroesophageal varices and portal hypertensive gastropathy are the most common and well known endoscopic findings in cirrhotic patients with Ascites. Substantial number of cirrhotic patients do bleed from variceal lesions seen in emergency department. For proper medical and/or Endoscopic treatment of varices in these patients these lesions needs to be identified. Upper GI endoscopy (EGD) remains the diagnostic procedure of choice for identification of the varices and helps in variceal management as well. The emphasis should be put on early and thorough endoscopic examinations aimed at proper diagnosis and therapy.

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