Sudden death due to ruptured oesophageal varices – autopsy-based case report

Sonwani, Nagendra Singh; Ateriya, Navneet; Kumar, Arvind; Kohli, Anil; Banerjee, Kalyan K.

doi:10.1177/0025817220926929

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Acute hemorrhage from ruptured GOV is a serious complication of portal hypertension among cirrhotic patients. It represents a medical emergency with high morbidity and mortality rates despite the major improvements achieved in the diagnosis and treatment [20], and that is why the current practice guidelines recommend all cirrhotic patients to be screened for the presence of GOV by an upper EGD [7,21].…”

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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Section: Discussionmentioning

confidence: 99%