Noninvasive Prediction of Esophageal Varices Grade (Size) in Sudanese Patients with Periportal Fibrosis
International Journal of Gastroenterology
Volume 2, Issue 2, December 2018, Pages: 28-33
Received: Oct. 30, 2018;
Accepted: Nov. 13, 2018;
Published: Dec. 19, 2018
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Mohammed Abdelrahim Hassan, Sudan Medical Specialization Board, Khartoum, Sudan
Amin Mohammed Abass, Department of Gastroenterology and Hepatology, Ibn Sina Teaching Hospital, Khartoum, Sudan
Hyder Osman Mirghani, Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
Elkhawad Osman, Depatment of Radiology, Ibn Sina Teaching Hospital, Khartoum, Sudan
Mohammed Osman Elhassan Gadour, Department of Internal Medicine, Faculty of Medicine, Omdurman Islamic University, Omdurman, Sudan
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Endoscopy is an effective tool for variceal grading, but it is costly, invasive, and not always at hand. The study aimed to assess platelets count and ultrasonographic parameters of portal hypertension as predictors of esophageal grade. This, cross-sectional hospital based study conducted among100 patients with Schistosomal portal hypertension at Ibn Sina Teaching Hospital, Khartoum, Sudan during the period from November 2011 – August 2012. Patients with liver cirrhosis, previous treatment for esophageal varices or on β blockers were not included. Information collected were: socio-demographic data, history of and onset of variceal bleeding, ascites, SchistosomaMansoni Score (SMS), the spleen size, liver span, portal and splenic veins diameter, variceal grade, and platelets count. The ethical committee of the Sudan Medical Specialization Board approved the research and the Statistical Package for Social Sciences (SPSS, version 20, New York) was used for data analysis. Participants (76% males), Mean age (43.9 ± 14 years), liver span, spleen size below the costal margin, and portal vein diameter were, 10.34± 2.01, 6 ± 3.9, and 1.5 cm ± 0.27 cm respectively. Platelets count, SMS, the extent of periportal fibrosis, and portal vein diameter were significant predictors of esophageal grade,(P-value <0.05), while spleen size, portal vein diameter, platelets/spleen index were not. The study concluded that, non-invasive assessment of ultrasonographic parameters (ShistosomaMansoni Score, portal vein diameter, degree of periportal fibrosis) and platelets count could aid the detection of patients with large esophageal varies for the implementation of the needed intervention. The limitation was the small sample size.
Predictors, Schistosomiasis, Esophageal Grade, Sudan
To cite this article
Mohammed Abdelrahim Hassan,
Amin Mohammed Abass,
Hyder Osman Mirghani,
Mohammed Osman Elhassan Gadour,
Noninvasive Prediction of Esophageal Varices Grade (Size) in Sudanese Patients with Periportal Fibrosis, International Journal of Gastroenterology.
Vol. 2, No. 2,
2018, pp. 28-33.
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Lee Goldman, Dennis Ausiello, Chapter 376 – Schistosomiasis (Bilharziasis), 23 edition CECIL medicine , SAUNDERS ELSEVIER 2008.
El Gadal AA. The Blue Nile Health Project: a comprehensive approach to the prevention and control of water associated diseases in irrigated schemes of the Sudan. Journal of Tropical Medicine and Hygiene.(1985); 88:57-63.
Ahmed ES, Daffalla A, Christensen NO, Madsen H.. Pattern of infection and transsimision of Schistosoma haematobium in White Nile province. Ann Trop Med Parasitol. (1996); 90(2): 173-80.).
Sherlock S, Dooly J. disease of the liver and biliary system, 11th edition ; chapter 29 , the liver in infection : (2002); pages 508-509.
Viallet A, Marleau D, Huet M, Martin FA, Villeneuve JP, Lavoie P. Haemodynamic evaluation of patients with intrahepatic portal hypertension.. Relationship between variceal and portohepatic gradient. Gastroentrol (1995); 69: 1297 -1300.
Rebouças G. Clinical aspects of hepatosplenic schistosomiasis: A contrast with cirrhosis. Yale J Biol Med. (1975); 48: 369–76.
Homeida M, Abdelgader AF, Cheever AW, Bennet JI, Arbab BM, Ibrahim SZ, Nash TE. Diagnose of pathologically confirmed symmer periportal fibrosis by ultrasonography. AM J Trop Med Hyg (1988); 38(1): 86-91.
Akande KO, Akere A, Otegbayo JA, Ola SO, Ousunmade D Accuracy of non-endoscopic predictors of oesophagealvarices in liver cirrhosis using platelet count, splenic size and portal vein diameter. Afr J Med Med Sci. (2016) ; 45(3): 243-251.
Chiodi D, Hernández N, Saona G, Sánchez A, Berrueta J, Mescia G, Pollio C, Robaina G. [Noninvasive diagnosis of esophageal varices in cirrhotic patients]. Acta Gastroenterol Latinoam. (2014); 44(2):108-13. [Article in Spanish].
Xu XD, Xu CF, Dai JJ, Qian JQ, Pin X. Ratio of platelet count/spleen diameter predicted the presence of esophageal varices in patients with schistosomiasis liver cirrhosis. Eur J Gastroenterol Hepatol. (2016); 28(5):588-91. doi: 10.1097/MEG.0000000000000584.
Agha A, Abdulhadi MM, Marenco S, Bella A, Alsaudi D, El-Haddad A, Inferrera S, Savarino V, Giannini EG. Use of the platelet count/spleen diameter ratio for the noninvasive diagnosis of esophageal varices in patients with schistosomiasis. Saudi J Gastroenterol. (2011); 17(5):307-11. doi: 10.4103/1319-3767.84483.
Manohar TP, Patil V, Salkar HR. Combination of non-endoscopic parameters as predictors of large esophageal varices. Trop Gastroenterol. (2014); 35(3): 173-9.
Nada L, Samira el F, Bahija B, Adil I, Nourdine A Noninvasive predictors of presence and grade of esophageal varices in viral cirrhotic patients. Pan Afr Med J. (2015); 20:145. doi: 10.11604/pamj.2015.20.145.4320. eCollection 2015.
Mahassadi AK, Bathaix FY, Assi C, Bangoura AD, Allah-Kouadio E, Kissi HY, Touré A, Doffou S, Konaté I, Attia AK, Camara MB, Ndri-Yoman TA. Usefulness of Noninvasive Predictors of OesophagealVarices in Black African Cirrhotic Patients in Côte d'Ivoire (West Africa). Gastroenterol Res Pract. (2012); 2012:216390. doi: 10.1155/2012/216390. Epub (2012).
Farid M, Abdelwahab G, Thomas GS. Ultrasonographic prediction of oesophagealvarices in Schistosomias ismansoni. Am J Gastrol (1995); 88 (4): 560-563.
Richter J, Correia AR, Vergetti JG. Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosomaisis mansoni. J Trop Med InteHealth (1998); 3(9): 728-735.
Mirghani HO, Khamees H. Predictors of Bleeding of Esophageal Varices Among Patients with Portal Hypertension-Sudan. American Journal of Biomedical and Life Sciences (2016); 4(6): 103-106. doi: 10.11648/j.ajbls.20160406.14.
Zaman, T. Becker, J. Lapidus, and K. Benner, “Risk factors for the presence of varices in cirrhotic patients without a history of variceal hemorrhage,” Archives of Internal Medicine. (2001); 161 (21): 2564–2570.