Study of right liver lobe diameter to the serum albumin ratio as a marker of esophageal varices in patients with cirrhosis of liver

Objectives To evaluate the effectiveness of the right liver lobe diameter to serum albumin (RLL/Alb) ratio as a non-invasive marker for predicting the presence and size of esophageal varices in cirrhotic patients, an area with limited research in India. Material and Methods This study involved cirrhotic patients who met specific inclusion and exclusion criteria. All participants underwent a comprehensive biochemical workup, esophagogastroduodenoscopy, and abdominal ultrasonography to measure the RLL/Alb ratio. Data were collected, tabulated, and analyzed. Results A total of 150 patients (117 males, 33 females) with an average age of 47.81 ± 8.99 years participated in the study. Alcohol consumption was the predominant cause of cirrhosis (64%). Patients were distributed across Child-Pugh classes A (34%), B (34%), and C (32%). Esophageal varices (EV) were absent in 21.3% of patients, while 24.6%, 40%, and 14% had grade I, II, and III EV, respectively. The mean RLL/Alb ratios for no varices, grades I, II, and III were 3.14 ± 0.69, 4.99 ± 0.57, 5.62 ± 0.83, and 7.63 ± 0.49, respectively. A strong positive correlation was observed (r = 0.8633). Conclusion The RLL/Alb ratio shows promise as a reliable, non-invasive tool for identifying and grading EVs in liver cirrhosis patients, especially valuable in settings where endoscopy resources are limited. This study highlights the need for accessible markers of varices in the Indian population, where research on this parameter is limited.