Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Esophageal varices (EV) are a common and severe complication of portal hypertension (PH). As esophagogastroduodenoscopy (EGD), the current method of investigating EV, has serious complications, our study aimed to predict the presence of EV in patients with chronic liver disease by non-invasive methods.Patients and methods: One hundred and twenty- four infant and children with chronic liver disease and underwent EGD and their age ranged between 6 months and 18 years old were included in our observational analytic study. All patients had no history of previous GIT bleeding, use of Ý- blockers, sclerotherapy or band ligation. Blood tests (complete blood count, coagulation profile and liver function tests) and abdominal ultrasound scan results were recorded. Spleen size, based on data from the ultrasound scan, was expressed as a standard deviation score relative to normal values for age and sex. Patients were classified regarding underlying pathology into 100 patients with intra-hepatic diseases and 24 patients with extra-hepatic diseases. The intra-hepatic group was further classified according to EGD finding into: 70 patients with EV and 30 patient without EV, while all patients of the extra-hepatic group had EV. Using the collected data, descriptive univerate analysis was performed on seven potential predictors of EV. Theses predictors were: platelets count, spleen z size (SZS), platelets count to spleen size (cm) ratio (PSR), platelets count/ SZS, clinical prediction rule (CPR), aspartate aminotransferase to platelet ratio index (APRI) and risk score. Multivariate logistic regression was then modeled on SZS and risk score as significant methods

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