Clinical Profile and Upper Gastrointestinal Endoscopic Findings of Patients Presenting with Liver Cirrhosis with Portal Hypertension

Chaudhary, Shatdal; Jaiswal, Niraj Kumar; Shahi, Aakash

doi:10.3126/jkahs.v3i1.27780

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…A study done in Bhairahawa, Nepal has studied the upper gastrointestinal findings of patients presenting with liver cirrhosis with portal hypertension. In this study Esophageal Varies, important cause of upper GI bleeding were seen in 51 (57.3%) patients, 4 however in our study UGI bleed was seen in 5.26% of portal hypertension patients.…”

Section: Discussioncontrasting

confidence: 60%

“…3 Another study in Nepal aimed to find out the upper GI endoscopic findings of patients presenting with liver cirrhosis with portal hypertension. 4 Similarly, other studies in similar settings had studied alcoholic liver disease in terms of its presentation, lab findings and complications. 5 , 6 Our study is different from these studies in a view that we had studied the prevalence of portal hypertension among CLD inpatients in a tertiary care center for the first time in Nepal.…”

Section: Discussionmentioning

confidence: 98%

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Portal Hypertension among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine of a Tertiary Care Centre

Khadka,

Aryal,

Karki

et al. 2023

J Nepal Med Assoc

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Introduction: Portal hypertension is increased pressure within the portal vein. A portal pressure gradient of more than 10 mmHg is defined as "clinically significant portal hypertension" due to manifestations such as splenomegaly, gastroesophageal varices, ascites, hepatorenal syndrome, hepatopulmonary syndrome, hepatic encephalopathy, and spontaneous bacterial peritonitis. The aim of this study was to find out the prevalence of portal hypertension among patients with chronic liver disease admitted to the Department of Internal Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with chronic liver disease in the Department of Internal Medicine of a tertiary care centre from 1 January 2021 to 31 December 2022 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 247 patients with chronic liver disease, the prevalence of portal hypertension was 38 (15.38%) (10.88-19.88, 95% Confidence Interval). A total of 16 (42.11%) patients were in the age group of 51-60 years and males were 36 (94.74%). Ascites as a complication were found in 4 (10.53%). Conclusions: The prevalence of portal hypertension among chronic liver disease inpatients in a tertiary care centre was found to be lower than other studies done in international settings.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 98%

Portal Hypertension among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine of a Tertiary Care Centre

Khadka,

Aryal,

Karki

et al. 2023

J Nepal Med Assoc

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“…EGD remains the gold standard maneuver in the management of GOV owing to its diagnostic as well as therapeutic potential [22]. However, the application of the screening policy among cirrhotics implies that a number of unnecessary endoscopies are carried out.…”

Section: Discussionmentioning

confidence: 99%

Does gallbladder wall thickness measurement predict esophageal varices in cirrhotic patients with portal hypertension?

Elkerdawy¹,

Ahmed²,

Zaghloul³

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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Background and study aim Endoscopy is the gold standard investigation for diagnosis of gastroesophageal varices (GOVs), yet it is invasive, associated with complications. Many noninvasive parameters were investigated to predict the presence of GOVs. The current study investigated gallbladder wall thickening (GBWT) measurement as a noninvasive predictor of GOVs in posthepatitic cirrhotic patients with portal hypertension. Patients and methods In this cross-sectional study, 105 cirrhotic patients were divided into, group I and II according to the presence or absence of GOVs, respectively. Group I subdivided into, groups A and B according to the grade of GOVs either nonadvanced (grades I and II) or advanced (grades III and IV), respectively. Complete history taking, full clinical examination, full investigations, upper endoscopy and abdominal ultrasonography were performed to examine all patients. Results Both groups were comparable in their baseline characteristics except for AST to Platelet Ratio Index and Fibrosis-4 scores, which were significantly higher in group I. GBWT, portal vein diameter and spleen length were significantly associated not only with GOVs but also with its advanced grades. GBWT at a cutoff level >3.1 mm can predict the presence of GOVs with 54.29% sensitivity, 97.14% specificity, 97.4% positive predictive value (PPV), 51.5% negative predictive value (NPV) and 68.5% accuracy. GBWT can predict advanced grades of GOVs at a cutoff level >3.5 mm, with 45% sensitivity, 90% specificity, 64.3% PPV, 80.4% NPV and 77.1% accuracy. Conclusion GBWT was associated with the presence of GOVs, and with advanced GOVs in posthepatitis cirrhotic patients with portal hypertension.

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“…reported varices of 95 %, whereas varices were present in 57.3% and 57.5% in study of Chaudhary et al15 and Bhattarai et al16 respectively. Further subtyping of varices cannot be compared because of the use of different grading system.…”

mentioning

confidence: 91%

Correlation of Child-Pugh Classification with Esophageal Varices in Patients with Liver Cirrhosis

Tiwari¹,

Thapa²,

Karki³

et al. 2022

J. Nepalgunj Med. College

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Introduction: The severity of the chronic liver disease can be assessed by several non-invasive methods one of them includes scoring system like Child-Pugh classification. Aims: The objective of this study was to assess the correlation of Child Pugh class with esophageal varices in patients with liver cirrhosis. Methods: This was a cross-sectional hospital-based study of 406 patients with liver cirrhosis. Demographic and relevant clinical data were collected using a standardized questionnaire. Abdominal ultrasound, liver function test, full blood count, viral markers were done for all patients. All patients underwent upper gastrointestinal endoscopy to screen for varices and if found were categorized as small and large. Results: A total of 406 patients with a mean age of 48 ± 11 years were evaluated. There were 72.4% and 27.6% men and women respectively. Variceal screening by upper gastrointestinal endoscopy revealed esophageal varices in 90.1% patients. By Child-Pugh Classification, 60 (14.8%) patients were in class A, 156 (38.4%) in class B and 190 (46.8%) in class C. Among patients with Child class A, 29 (48.3%) had varices. Similarly, 147 (94.2%) and 190 (100%) of Child class B & C had varices respectively. Odds of presence of esophageal varix were 9 times higher for patients with Child-Pugh Classification B and C compared to class A. Conclusion: Most patients with cirrhosis present late and with advanced stage in this referral center. Most have esophageal varices on their first screening endoscopy. Child-Pugh classification is a reliable measure of stratifying variceal risk in chronic liver disease patients.

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Clinical Profile and Upper Gastrointestinal Endoscopic Findings of Patients Presenting with Liver Cirrhosis with Portal Hypertension

Cited by 5 publications

References 14 publications

Portal Hypertension among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine of a Tertiary Care Centre

Portal Hypertension among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine of a Tertiary Care Centre

Does gallbladder wall thickness measurement predict esophageal varices in cirrhotic patients with portal hypertension?

Correlation of Child-Pugh Classification with Esophageal Varices in Patients with Liver Cirrhosis

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