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Νon-invasive screening for esophageal varices in patients with liver cirrhosis

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Annals of Gastroenterology   

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Νon-invasive screening for esophageal varices in patients with liver cirrhosis (EN)
Konstantakis, Christos
Thomopoulos, Konstantinos
Aggeletopoulou, Ioanna
Karatzas, Andreas
Triantos, Christos
Kalogeropoulou, Christina
Esophageal varices are one of the main complications of liver cirrhosis. Upper gastrointestinal endoscopy is the gold standard for the detection of esophageal varices. Many less invasive methods for screening of varices have been investigated and the most recent Baveno VI guidelines suggest that endoscopy is not necessary in patients with liver stiffness <20 kPa and platelets >150,000/μL. A critical review of the literature was performed concerning non-invasive or minimally invasive methods of screening for esophageal varices. Liver and spleen elastography, imaging methods including computed tomography, magnetic resonance imaging and ultrasound, laboratory tests and capsule endoscopy are discussed. The accuracy of each method, and its advantages and limitations compared to endoscopy are analyzed. There are data to support the Baveno VI guidelines, but there is still a lack of large prospective studies and low specificity has been reported for the liver stiffness and platelet count combination. Spleen elastography has shown promising results, as there are data to support its superiority to liver elastography, but it needs further assessment. Computed tomography has shown high diagnostic accuracy and can be part of the diagnostic work up of cirrhotic patients in the future, including screening for varices. Keywords Esophageal varices, elastography, computed tomography, magnetic resonance imaging Ann Gastroenterol 2018; 31 (3): 305-314 (EN)
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Hellenic Society of Gastroenterology
Annals of Gastroenterology
Review Articles
English
2018-05-02
http://www.annalsgastro.gr/index.php/annalsgastro/article/view/3661
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 31, No 3 (2018); 305 (EN)
Copyright (c) 2018 Annals of Gastroenterology (EN)



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