Blood Ammonia Level Predicts The Presences of Esophageal Varices in Patients of Liver Cirrhosis Due to Hepatitis B And C Viruses

Abstract

Objective: To determine the biochemical and ultrasonographic non invasive parameters in liver
cirrhotic patients due to Hepatitis B and C virus. To validate the non invasive parameters with the
presence of esophageal varices using endoscopy as gold standard.
Material and Methods: Two hundred diagnosed patients were taken. Every patient underwent
esophagogastroduodenoscopy (EGD) for the presence of esophageal varices. Ultrasonography
was done to calculate the spleen diameter. Blood samples were taken to find the levels of blood
ammonia and platelet count.
Results: On the basis of Receiver operating curve (ROC) blood ammonia level had area under
the curve (AUC) 1.000 (p<0.001) platelet count/spleen diameter ratio (AUC=0.008, p<0.001)
platelet count (AUC 0.009, p<0.001) and spleen diameter had area under the curve 0.986
(p<0.001). The maximum area under the curve was observed with blood ammonia (100%) as
compared to other parameters.
Conclusion: It was concluded from the present study that blood ammonia level is the most
reliable non invasive parameter in predicting the presence of esophageal varices as compared to
other non invasive parameters