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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 3  |  Page : 1113-1118

Right liver lobe diameter/serum albumin ratio in the prediction of esophageal varices in cirrhotic patients


1 Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
2 Department of Diagnostic Radiology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
3 Department of Tropical Medicine, Shibin El Kom Teaching Hospital, Shebeen El-Kom, Egypt

Correspondence Address:
Ahmad Y. H. Metwally
Shibin El Kom 32511, Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_73_19

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Objective This study aimed to assess the role of right liver lobe diameter by ultrasound/albumin ratio in the prediction of esophageal varices (OV) in cirrhotic patients. Background OV often develop in cirrhotic patients. Varices rupture leading to variceal bleeding represents the most lethal complication of cirrhosis. Right liver lobe diameter/albumin (RLLD/Alb) ratio is a noninvasive method to predict the presence of OV. Patients and methods A case–control study was carried out on 200 cirrhotic patients (145 with OV and 55 without OV). Patients were subjected to complete blood picture, liver and kidney functions, viral markers, abdominal ultrasonography, upper gastrointestinal tract endoscopy, and calculation of the RLLD/Alb ratio and the platelet count/spleen diameter (PC/SD) ratio. Results The RLLD/Alb ratio was diagnostic for the prediction of OV with high significance (P ≤ 0.0001). At a cut-off point of 3.7, the sensitivity, specificity, and accuracy to predict OV were 95, 76.4, and 90%, respectively, with area under the curve = 0.88. A highly statistically significant difference was also noted in the PC/SD ratio with a sensitivity, specificity, and accuracy of 83.4, 70.3, and 80.9%, respectively, at a cut-off point of 605. A statistically significant positive correlation was found between both the RLLD/Alb ratio and the PC/SD ratio and grades of OV and the risk of bleeding from varices (P = 0.0001). Conclusion The RLLD/Alb ratio and the PC/SD ratio are useful as noninvasive predictors of OV in cirrhotic patients.


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