Background and Study aim: Liver cirrhosis is the main leading cause of esophageal varices. Loss of architecture with ‎subsequent portal hypertension leads to disturbance of blood flow in hepatic circulation. Hepatic ‎venous waveform and its degree of damping are valuable non-invasive tools to foresee the ‎existence of esophageal varices‎‎‎.‎The aim of this study is to evaluate the value of hepatic vein waveforms (HVW) and damping index (DI) in prediction of ‎the presence of esophageal varices in cirrhotic patients as a non-invasive tool to discriminate the ‎patients who need upper endoscopy from those who don't need‎‎.
Patients and Methods: ‎‎‎ This cross-sectional study included 48 cirrhotic patients (as evidenced with history, clinical ‎examination, biochemical data and pelviabdominal ultrasound) which were divided into 2 groups ‎according to presence of esophageal varices. Group (I): 26 patients with esophageal varices. ‎Group (2): 22 patients without esophageal varices‎‎‎.‎
Results: Twenty five out of 26 patients (96.2%) with esophageal varices and 90% of patients in Child ‎Pugh class C had monophasic waveform. There is no significant relation between severity of ‎ascites and HVW. Among all patients, 30 patients (62.5%) had DI >0.6, without significant ‎predominance to presence of esophageal varices, certain Child Pugh class, degree of ascites or ‎certain HVW. There is significant correlation between damping index and Child Pugh score‎‎‎‎.
Conclusion: Monophasic hepatic vein waveform is a good non-invasive indicator for the presence of ‎esophageal varices and advanced cirrhosis. DI is of no value in predicting esophageal varices, but ‎significantly correlated with Child Pugh score‎‎‎‎.