Prevalence of Oesophageal Varices in Newly Diagnosed Chronic Liver Disease Patients at The Jos University Teaching Hospital, Jos

Abstract

Background: Variceal bleeding is an important complication of portal hypertension and a major cause of death in patients with chronic liver disease (CLD) world wide. This study was carried out to document the occurrence of oesophageal varices and its clinical correlates among 80 Nigerian patients with CLD.

Patients and Methods: Eighty patients with CLD were stratified into three groups based on Child- Turcotte- pugh's classification for severity of CLD in a one year study. They had upper gastrointestinal endoscopy to detect and characterize varices.

Results: Sixty (75%) of the patients had oesophageal varices at endoscopy with 88.3% having grade 2 or 3 varices while 73.3% had moderate/large varices. Thirty five percent of the varices had “red signs” with “red whale” markings as the predominant red sign. Gastric varices were seen in 12.5%. Variceal size was significantly associated with severity of liver disease (P<0.05) as 90% of the patients with varices presented with Child's class B or C. A multiple logistic regression analysis identified advancing age, ascites, shrunken liver span and low platelet count as independent predictors of oesophageal varices.

Conclusion: A large proportion of Nigerian CLD patients have advanced at-risk-for-bleeding oesophageal varices at diagnosis. Early diagnosis of CLD in Nigerians is warranted.

Key words: Prevalence, Oesophageal varices, Chronic liver disease, Cirrhosis