Sindhu, P (2016) A Study on Child Pugh Score as a Non Endoscopic Predictor of Oesophageal Varices in patients with Alcoholic Liver Disease. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Alcoholic liver disease is the commonest liver disease in India with one in five Indians affected by some kind of liver disease related to alcohol. Variceal bleed is the second commonest cause for mortality accounting to 20% in patients with alcoholic cirrhosis. Currently as per recommendations all cirrhotic patients are advised to undergo endoscopic screening at the time of diagnosis that has its own practical difficulty. Hence, search for other non endoscopic parameters to detect the presence of esophageal varices at the first visit is a necessity. Child Pugh score is a simple bedside tool to diagnose the presence of esophageal varices and its severity. AIM AND OBJECTIVES: To correlate the presence and severity of esophageal varices to Child Pugh score and also to study the age and sex incidence of esophageal varices in patients with alcoholic liver disease and also to assess the significance of other non endoscopic variables with the presence of esophageal varices. MATERIALS AND METHODS: 106 patients with significant alcohol intake who were admitted in Institute of Internal Medicine, Madras Medical College & RGGGH, Chennai were enrolled in the study for a period of 6 months. Study was an observational study, all patients underwent thorough clinical examination followed by necessary lab investigations, USG, endoscopic after informed consent. Each patients were then assigned the CTP score and the findings were recorded and statistically analysed with independent and paired (ANOVA) sample test. RESULTS: Majority of the patients with alcoholic cirrhosis were in the middle age group (Mean age – 43.2yrs) and belongs to CTP score B (52.8%). Males commonly involved (95.3%). Patients with pallor, icterus, spider naevi, splenomegaly had large varices. Patients with higher degree of varices had low hemoglobin, hypoalbuminemia, and prolongation of INR. Platelet count, Portal vein diameter and Child Turcotte Pugh score showed a significant p value of < 0.001 correlating with the presence and severity of esophageal varices. CONCLUSION: Variceal bleed carries a significant morbidity and mortality in patients with alcoholic liver disease. Hence early detection of varices is of prime importance. To prevent the endoscopy as the only cornerstone for the diagnosis of esophageal varices, several non endoscopic parameters were assessed including Child Pugh score, platelet count, portal vein diameter that may be helpful especially in a peripheral setup were endoscopic facilities are not readily available.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201311013 |
| Uncontrolled Keywords: | Child Pugh Score ; Non Endoscopic Predictor ; Oesophageal Varices ; patients ; Alcoholic Liver Disease. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 06 Feb 2019 12:00 |
| Last Modified: | 06 Feb 2019 12:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/10527 |
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