Muhammad Umar, Seema Kanwal, Amir Rizwan Chohan, Sofia Chohan, Haider Z Baqai, Hamama tul Bushra Khaar, Shakeel Ahmed, Syed Fahd Shah, Sulaiman A Rathore, Mohammad Hanif.
Pattern of Esophageal Varices and Portal Gastropathy in HCV Related Cirrhosis.
Pak J Gastroenterol Jan ;17(1):20-3.

The risk of bleeding from esophageal varices is related to patient`s modified Child`s Class, size of varices and the presence of red wale markings. This study was designed to see different patterns of varices and portal gastropathy in Pakistani population. A total of 100 patients with esophageal varices were included in the study. The modified Child`s Pugh Class according to standard criteria, grading of varices according to Japanese Research Society and extent of varices in longitudinal columns was documented. The risk for bleed on the basis of red wale markings and portal gastropathy was also noted. Out of 100 cases 73 (73 %) were male and 27 (27%) were female with mean age of 53.76 ± 8.52 years and age range of 35 - 75 years. 19 patients were in Child`s Class A while 51 and 30 patients in Child`s B and C respectively. 11 patients with F 1 varices, 31 patients F 2, 42 patients F 3 and 16 patients with F 4 varices were found. One column varices were found in 8 patients while 23, 50 and 19 patients with two, three and four columns of varices were observed with a mean of 2.8 ± 0.8 columns. Portal gastropathy was found in 38 patients with standard deviation of 0.487. There were red wale markings present in 19 patients out of which 78.9% (15) were male and 21.1% (4) were female. It is concluded that HCV infection and its complications due to long incubation period of the virus commonly affect middle-aged males. Most of the patients lie in Child`s B and C (n=81) having F2 and F3 varices (n=73), moreover, 2-3 columns of varices are found in 73 patients. Risk of developing varices is high in cirrhosis and almost directly proportional to severity of cirrhosis (Child`s class). Bleeding is more frequent in males with large size of the varices, presence of red wale markings and Modified Child`s Class C.

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