Prevalence of gastric varices in cirrhotic patients presenting with upper GI bleed at Shifa International hospital: an insidious threat

Liver cirrhosis (LC) is a serious condition occurring as a result of chronic liver disease. Amongst its various complications, acute variceal bleeding is the most feared, which presents as esophageal, gastroesophageal, and isolated gastric varices (IGV). The existing literature on the epidemiology of Gastric Varices in cirrhotic patients is very deficient. Hence, we aim to find the prevalence of gastric varices in liver cirrhotic patients undergoing OGD with complaints of upper GI Bleed at Shifa International Hospital, Islamabad (SIH). We conducted an analytical cross-sectional study at the Department of Gastroenterology, Shifa international hospital, Islamabad. Our study spanned a period of six months after approval of the synopsis from 01-Feb till 01-Aug-22. Quantitative and qualitative data were collected, presented, and analyzed. We then applied the Post-stratification chi-square test, taking a p-value of ≤ 0.05 as significant. A total of 186 patients were included in this study. Mean age and duration of liver cirrhosis were 58.69 ± 8.39 years and 4.72 ± 2.24 years, respectively. 91 (48.9%) were males and 95 (51.1%) were females. 34 (18.3%) had and 152 (81.7%) did not have gastric varices. The stratification of various factors showed no significance concerning GV except for educational status, which was significant with a p-value of 0.01. Gastric varices are among the rare but serious complications of portal hypertension due to LC. A total of 186 patients were included in our study out of which 34 (18.3%) had gastric varices. The existing predictive markers, like age and Child Pugh Score, etc., showed no significant association, which shows that existing literature is very deficient and new protocols need to be included for better patient care. Our study has certain limitations, such as a lack of pediatric population data, a limited sample size, selection bias, lack of multi variate analysis and a single-center study.