الفهرس 
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Abstract
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ortal hypertension Portal hypertension is the central driver of complications in patients with chronic liver diseases and cirrhosis. The diagnosis of portal hypertension has important prognostic and clinical implications. In particular, Screening for varices in patients with portal hypertension can effectively reduce the morbidity and mortality of variceal Bleeding (Leung et al., 2017).
Transient Elastography is good non-invasive predictor of Esophageal varices Castera et al. (2012), Elastography-based measurement of liver stiffness (LSM) and spleen stiffness(SSM) represent valuable non-invasive screening tools for esophageal varices (Paternostro et al., 2019).
With this in mind, in our study we used the Spleen stiffness &liver Stiffness measurements by TE. The aim of this work was to identify parameters which might non-invasively predict the presence of any OV in patients of chronic liver disease and in the same time to assess the predictiveness of these identified rules in patients with cirrhosis.
61 cases with chronic liver disease were selected. Upper gastro-intestinal endoscopy was done for all cases for the presence of OV; accordingly the patients were then divided into three groups according to the presence/absence of any esophageal varices and its grading.
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Control group: 20 patients with liver cirrhosis and without esophageal varices.
group I (small sized O.V): 20 patients with liver cirrhosis and small size esophageal varices.
group II (medium and large sized O.V): 21 patients with liver cirrhosis and medium to large esophageal varices.
We evaluated the biochemical parameters for all patients, including: total and direct bilirubin, ALT, AST, alkaline phosphatase, serum albumin, prothrombin time, INR, and CBC including platelet count. Also, an ultrasonography of the abdomen was done to measure the maximal spleen bipolar diameter, PV diameter, ascites. We also measured spleen & liver stiffness using fibroscan for all patients.
We found that, spleen stiffness and Liver Stiffness measured by TE were significantly different among patients with esophageal varices when compared to those without esophageal varices.
The best cut off point for SS for prediction of esophageal varices in patients with chronic liver disease was 61.25Kpa with sensitivity of 86% and specificity of 74.5% according to our results.
The best cut off point for LS for prediction of esophageal varices in patients with chronic liver disease was 33.50 KPa with sensitivity of 81% and specificity of 69% according to our results.