Relación entre los hallazgos de endoscopia digestiva alta y baja en cirróticos descompensados evaluados son Scores MELD y Child Pugh para trasplante hepático. Hospital Luis Vernaza. Enero 2016 - diciembre 2017.

Abstract

Introduction: Liver Cirrhosis, the final stage of liver fibrosis, was the 10th cause of death in the world (2010) and the 7th cause in Ecuador (2014). Adequate screening and a timely diagnosis improves survival. Objective: The objective of this study is to correlate the findings of digestive endoscopy in cirrhotic patients evaluated for liver transplantation, with MELD and CHILD-PUGH scores, and to identify the factors that influence the presence of esophageal varices. Materials and methods: We evaluated 120 decompensated cirrhotic patients (49.2% women, 50.8% men, average age 56.1 years) undergoing pre -liver transplant evaluation at Luis Vernaza Hospital. Demographic data and laboratory results were collected to obtain MELD and CHILD-PUGH scores and the results of high and low endoscopies were described. Results: The most frequent cause of cirrhosis was nonalcoholic steatohepatitis(50%), followed by autoimmune (19.2%), cryptogenic (17.5%) alcohol (8.3%), viral (1.7%) among others (3.3%). 55.8% of patients were located in CHILD PUGH B, and 68 (82.8%) in MELD 10-19. The most frequent endoscopic findings were esophageal varices (83.3%), most commonly found in men (93.4%, p = 0.002), under 20 years (100%, p= 0.05) and in CHILD PUGH B and C classes (86.5% and 87.5% respectively, p= 0.002) with higher MELD scores (p = 0.11). Large and small esophageal varices with hypertensive gastropathy (27.3%) were more frequent in CHILD PUGH C, followed by large esophageal varices (21.2%). Small varices (30%) are more frequent in CHILD PUGH A (p= 0.002).