Fibroscan in Grading and Prediction of the Risk of Bleeding of Gastro-Esophageal Varices in HCV related Cirrhotic Patients

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Background: By measuring liver stiffness (LS) with transient elastography (TE), portal hypertension and the presence of oesophageal varices (OV) were investigated. In HCV-related cirrhotic individuals, fibroscan is capable of predicting the presence of esophageal varices. And probable categorization based on degree of hepatic rigidity. Objective: This research aimed to use fibroscan and a prospective grade based on degree of liver stiffness as a means of diagnosing esophageal varices earlier in people with cirrhosis caused by HCV. Methods: Ultrasonography was used to evaluate 250 Egyptian HCV-related cirrhotic patients, aged >18, with a BMI of < 35 and no history of ascites, GIT hemorrhage, HCC, abdominal collaterals, portal or splenic vein thrombosis. They classified the varices as group I (no varices), group II (little varices), and group III (big varices). Results: All Groups were matched for age and BMI. In group III, Platelet count was lower & MELD was higher significantly than in groups I & II (115.4 ± 41.6 vs149.6 ± 60.6 & 132.1 ± 44.9 & 12.1 ± 2.9 vs 9.1 ± 2.5 & 10.1 ± 2.2 respectively. Mean LS in group I vs II & III was 20.5 ± 4.3 vs 40.5 ± 11.9 & 61.4 ± 13.1. Cutoff value for presence of OV: 27.3 Kpa (sensitivity 92.5% & specificity 98%), while LS cutoff value between group II & III: 40.9 Kpa (sensitivity 93% & specificity 52%). LS in bleeding vs none bleeding OV was 66.6 ± 10.5 vs 43.8 ± 18.8), cutoff value 55.7 Kpa (sensitivity 91.7% & specificity 73.5%). Conclusion: Liver cirrhosis patients may benefit from anticipating the existence of esophageal varices by evaluating liver stiffness using a fibroscan. It may also aid in selecting patients for endoscopic screening because other non-invasive criteria can't compare to its accuracy at predicting the size of esophageal varices.