Evaluation of the Gallbladder Wall Thickening as a Non-invasive Predictor of Esophageal Varices in Cirrhotic Patients

Abstract

Background: Liver cirrhosis represent the end stage of fibrosis that destroy normal liver parenchyma and leads to serious complication as portal hypertension which result in esophageal varices (EV), EV bleeding leads to high mortality, so repeated upper endoscopy needed to control bleeding which is invasive procedure and of high risk of hazards as infection. Our Study Aimed: to evaluate the Gallbladder Wall Thickening (GBWT) as a non-invasive predictor of Esophageal Varices (EV) in cirrhotic patients. Methods: In this cross sectional study, we tested 120 cirrhotic patients at gastroenterology and hepatology unit, internal medicine department, Tanta university hospitals. They were divided into 60 cirrhotic patients with EV and 60 cirrhotic patients without EV. All patients were subjected to history taking,  physical examination, investigation (complete blood count, liver function tests, viral markers) ultrasound detecting (gall bladder wall thickness, portal vein diameter, portal vein flow velocity, portal cross sectional area and gall bladder fasting volume) upper gastrointestinal endoscopy to detect presence or absence of varices. Results: Significant correlation was observed between gall bladder wall thickness (GBWT) and portal hypertension, GBWT ranged from 2.5 to 7 mm in group 2 (cirrhotic patients with EV) and from 1.5 to 5 in group 1( cirrhotic patients without EV). There is significant difference between group 1 and group 2 as regard GBWT with (P value < 0.05), portal vein diameter (PVD) with (P value <0.05) and platelets counts with (P value <0.05). Conclusions: We recommend thatgall bladder wall thickness can be used as a non-invasive predictor of esophageal varices in cirrhotic patients.