EGD vs EUS in Diagnosing Portal Hypertension in Cirrhotic Patients.
EGD vs EUS in Diagnosing Portal Hypertension in Cirrhotic Patients.
Liver cirrhosis with the further development of portal hypertension implies structural and
 vasculature alteration in the portosplenic circulation.

 Esophagogastroduodenoscopy is the standard of care for the detection and treatment of
 esophageal varices, as esophageal varices serve as a surrogate for estimating a portal
 pressure gradient > 10 mmHG.

 Endoscopic ultrasound evaluation allows the detection of peri-esophageal collateral veins,
 perforating veins and para-esophageal collateral veins, which has demonstrated to be
 effective for the prediction of esophageal varices recurrence after variceal eradication.

 The investigators aimed to compare esophagogastroduodenoscopy versus endoscopic ultrasound
 evaluation for the early diagnosis of portal hypertension in cirrhotic patients.
A randomized control trial of 70 cirrhotic patients randomly submitted for
 esophagogastroduodenoscopy (35 patients) or EUS evaluation (35 patients) for the diagnosis of
 portal hypertension.

 The portal pressure gradient will be defined based on portal vein catheterization via
 interventional radiology.

 Esophagogastroduodenoscopy will evaluate the presence and grade of esophageal varices,
 presence and type of gastric varices, presence and signs of hypertensive gastropathy.

 Endoscopic ultrasound will evaluate the presence of esophageal varices, the presence of
 gastric varices and the EUS- signs og hypertensive gastropathy, Azygos vein diameter, mean
 velocity and blood flow volume index.
Inclusion Criteria:

 -  Above 18 years old

 -  Willingness to participate in the study

 -  Compensated liver cirrhosis based on clinical and imaging findings

 -  Written informed consent provided

 Exclusion Criteria:

 -  Decompensated liver cirrhosis: ascitis, encephalopathy, gastrointestinal bleeding,
 infection

 -  Hemodynamic instability

 -  Pregant or nursing patients

 -  Patients with history of esophageal, gastric, liver, pancreas and spleen tumors

 -  Severe uncontrolled coagulopathy

 -  Any contraindication for portal pressure gradient meassurement via radiological
 evaluation.