RELATIONSHIP BETWEEN LIVER DISEASE SEVERITY (CHILD-PUGH CLASS) AND ENDOSCOPIC FINDINGS IN VARICEAL SCREENING
DOI:
https://doi.org/10.71000/c8qqts15Keywords:
Esophageal and Gastric Varices; Gastrointestinal Endoscopy; Liver Cirrhosis; Portal Hypertension; Severity of Illness Index; Splenomegaly; Upper Gastrointestinal TractAbstract
Background: Cirrhosis commonly leads to portal hypertension, resulting in gastroesophageal varices and other endoscopic manifestations that may progress to serious bleeding complications. Upper gastrointestinal endoscopy remains the standard method for variceal screening, but access may be limited in busy or resource-constrained settings. The Child-Pugh classification is a simple clinical score for assessing liver disease severity and may help identify patients at greater risk of significant endoscopic abnormalities.
Objective: This study aimed to determine the relationship between liver disease severity, assessed by Child-Pugh class, and endoscopic findings among patients undergoing variceal screening.
Methods: A cross-sectional observational study was conducted on 100 consecutive patients with chronic liver disease and portal hypertension. Demographic characteristics, clinical history, etiology of liver disease, medication use, laboratory parameters, and Child-Pugh scores were recorded. All patients underwent upper gastrointestinal endoscopy for assessment of esophageal varices, variceal grade, gastric varices, portal hypertensive gastropathy, ascites, and high-risk endoscopic stigmata. Data were analyzed using descriptive statistics, Pearson’s chi-square test, linear-by-linear association, Spearman rank correlation, binary logistic regression, Mann-Whitney U test, and receiver operating characteristic curve analysis.
Results: The cohort included 66 males and 34 females, with a mean age of 54.97 ± 8.22 years. Esophageal varices were present in 82 patients, including Grade I in 29, Grade II in 21, and Grade III in 32 patients. Gastric varices were observed in 38 patients, portal hypertensive gastropathy in 63, high-risk stigmata in 32, and ascites in 76. Child-Pugh class A, B, and C were present in 25, 45, and 30 patients, respectively. Grade III varices were found in 16.0% of class A, 26.7% of class B, and 53.3% of class C patients. Child-Pugh class was significantly associated with variceal grade (χ² = 26.367, p < 0.001), and Child-Pugh score showed a positive correlation with variceal severity (rs = 0.413, p < 0.001). The area under the curve for Child-Pugh score predicting large varices was 0.671.
Conclusion: Higher Child-Pugh class was associated with more severe esophageal varices and clinically important endoscopic findings. Child-Pugh scoring may support risk-based prioritization for endoscopic screening and prophylactic management, especially where endoscopy access is limited.
Keywords: Esophageal and Gastric Varices; Gastrointestinal Endoscopy; Liver Cirrhosis; Portal Hypertension; Severity of Illness Index; Splenomegaly; Upper Gastrointestinal Tract
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Copyright (c) 2026 Samiyya Rasool Abbasi, Dr Shabnam Naveed, Hiba Khairat Rizvi, Momina Mazhar Ali, Dr Zeeshan Ali, Anjli (Author)
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