Transient elastography has emerged as a non-invasive alternative to upper endoscopy for identifying gastric and esophageal varices in patients with chronic hepatitis B and hepatitis C.
Submission: 21 June 2023 | Acceptance: 26 July 2023 | Publication: 24 November 2023
1 Dr. Sadaf Anwar Qureshi, 2Kazim Raza, 2Tabassum Butt, 2Qasim Aurangzeb,
1Assistant Professor, Department of Pathology, Ayub Medical College, Abbottabad
2PIMS Islamabad
Corresponding: Dr. Sadaf Anwar Qureshi, Assistant Professor, Department of Pathology, Ayub Medical College, Abbottabad
ABSTRACT
Lack of early diagnoses of hepatitis Band C, many patients remain untreated till later stages leading to progression of chronic liver disease to decompensation and complications. When there is portal hypertension, it leads to portosystemic shunting by forming collateral vessels. 1 This results in the formation of esophageal and gastric varices which results in complications of decompensation by causing massive hemorrhage. Which can be life threatening and raises the mortality rate up to 14.2 – 14.5%. 2,3 Esophageal and Gastric varices are one of the signs of the progression of chronic liver disease to cirrhosis. This is because of the development of portal hypertension in response to progression of fibrosis and increase stiffness in patients with chronic liver disease secondary to hepatitis B and C. The recent updates in guidelines of Baveno 7, emphasizes on the importance of screening of patients with chronic liver diseases for the identification of esophageal/ gastric varices and further management of the patients accordingly because the surveillance interval and treatment strategies rely on the grade of varices.
Many studies have been conducted in the past that have shown that an average of 50% of patients who were initially diagnosed with cirrhosis, do not develop esophageal varices in the period of follow up of 10yr. 4
Keywords: Transient elastography, non-invasive alternative, upper endoscopy, identifying gastric, esophageal varices, chronic hepatitis B and hepatitis C.