Decompensated cirrhosis; prevalence of gastric varices

Cirrhosis with subsequent portal hypertension is a major health problem worldwide. Among various etiologies, HCV is the leading cause of chronic hepatocellular injury. Cirrhosis being the commonest cause of portal hypertension results in a spectrum of complications. Approximately 5-15% of cirrhotic develop varices. Gastric varices although present less frequently as compared to esophageal varices but are associated with greater mortality and morbidity

Objectives: To determine prevalence of Gastric varices in patients with decompensated cirrhosis

Study Design: Cross sectional study

Place and Duration: Carried out at two centers, Pakistan Ordinance Factories Hospital Wah Cantt and Shalimar Hospital Lahore from Jan 2014 to Jan 2015

Subjects: A total of 421subjects of decompensate cirrhosis were included in the study

Methods: Patients with decompensate cirrhosis of any etiology who were visiting the two hospitals as inpatient or outpatient were included in the study. Upper GI endoscopy was done in all these subjects for determination of gastric varices

Results: Among 421 patients of decompensate cirrhosis, frequency of gastric varices was 10.9%, GOV1 as the most common variant. Gastric varices contributed to 5.4% of all variceal bleeds

Conclusion: Gastric varices are found in significant number of patients of decompensate cirrhosis. Since gastric varices are associated with increased mortality and poor outcomes, these should be carefully looked during upper GI endoscopy. Successful management of gastric variceal hemorrhage necessitates availability of expertise and newer diagnostic modalities

Impact of open access endoscopy on early diagnosis, treatment and gastrointestinal radiology service

The objective is to compare the endoscopic findings before and after initiation of open access and its effect on gastrointestinal radiology services. The data of endoscopic findings before open access endoscopy [july, 1989-June, 1992] and after open access endoscopy [July, 1992-June, 1995] was collected from the records of the endoscopy unit. Similarly, data of barium meals for the same periods was collected from the radiology department. An X2 test was used to compare the endoscopic findings before and after open access policy. It is found that open access endoscopy increased the workload in the endoscopy unit but at the same time reduced the number of gastrointestinal radiological procedures. It reduced the wailing period for endoscopy and this helped in making early diagnosis and initiation of appropriate treatment