Cirrhosis is a late stage of progressive hepatic fibrosis which is a consequence of almost all chronic liver diseases; the main causes of liver cirrhosis are chronic viral infections (B, C or B+D), alcoholic etiologies and lately non alcoholic fatty liver disease (NAFLD) (1). Around 50% of patients with cirrhosis have esophageal varices (EV), and one-third of all patients with varices will have variceal hemorrhage, representing an incidence of 5% and 15% in patients with small and large oesophageal varices, respectively (2). Esophageal varices are known to develop after increasing in hepatic venous pressure gradient to more than 10–12 mmHg (2, 3).
Several methods have been used to decrease the incidence of variceal bleeding in patient with …show more content…
As a result, those patients will undergo unnecessary endoscopies which are invasive, discomfort, and could limit patients’ compliance. Thus, selecting patients with large esophageal varices that are at high risk of bleeding has recently gained more attention.
Moreover, considerable attempts have been made either to propose a non-invasive method or to narrow the practice of using endoscopy only to high-risk patients. The non-invasive methods include: platelet count, spleen diameter measurement, ratio of the platelet count to the spleen size, serum albumin level, and lower esophageal wall thickness (8, 9). Since less invasive methods cannot substitute endoscopy, determining whether clinical or laboratory parameters could detect the presence of large esophageal varices has become a matter of …show more content…
TE has been used in staging of chronic hepatopathies particularly chronic hepatitis B and C, NAFLD, and in post-transplant patients (10-12, 17-19). Moreover, TE also showed potential value in EV prediction in patients with cirrhosis (20-23). TE is performed with a FibroScan® device, that have a transducer probe fixed on the axis of a vibrator. Vibration is generated by the vibrator that produces an elastic shear wave which propagates into the liver. The shear wave velocity (expressed in KiloPascals - kPa) is directly measure the stiffness of the tissue
Several methods have been used to decrease the incidence of variceal bleeding in patient with …show more content…
As a result, those patients will undergo unnecessary endoscopies which are invasive, discomfort, and could limit patients’ compliance. Thus, selecting patients with large esophageal varices that are at high risk of bleeding has recently gained more attention.
Moreover, considerable attempts have been made either to propose a non-invasive method or to narrow the practice of using endoscopy only to high-risk patients. The non-invasive methods include: platelet count, spleen diameter measurement, ratio of the platelet count to the spleen size, serum albumin level, and lower esophageal wall thickness (8, 9). Since less invasive methods cannot substitute endoscopy, determining whether clinical or laboratory parameters could detect the presence of large esophageal varices has become a matter of …show more content…
TE has been used in staging of chronic hepatopathies particularly chronic hepatitis B and C, NAFLD, and in post-transplant patients (10-12, 17-19). Moreover, TE also showed potential value in EV prediction in patients with cirrhosis (20-23). TE is performed with a FibroScan® device, that have a transducer probe fixed on the axis of a vibrator. Vibration is generated by the vibrator that produces an elastic shear wave which propagates into the liver. The shear wave velocity (expressed in KiloPascals - kPa) is directly measure the stiffness of the tissue