Background: The number of patients undergoing screening endoscopy for the presence of esophageal varices (EV) is increasing in Egypt as a result of the growing pool of patients with chronic liver diseases.

Aim: The aim of the present study was to identify clinical, biochemical, and ultrasonographic parameters which might non-invasively predict the presence of EV in patients with liver cirrhosis.

Patients and methods:Two hundred patients with liver cirrhosis, 118 males and 82 females with a mean age of 50±12.07 years, were included. They underwent complete biochemical workup, esophagogastroduodenoscopy, and ultrasonographic measurement of spleen bipolar diameter and portal vein diameter. Platelet count/ spleen diameter ratio was calculated for all patients.

Results: The prevalence rate of EV among our patients was 62%. There were no significant differences regarding serum bilirubin and albumin concentration, aminotransferases, alkaline phosphatase or Child- Pugh score among patients without (group I) or with EV (group II). Conversely, Prothrombin INR, platelet count/spleen diameter ratio (at a cut-off value of ≤909) was the most significant parameter independently associated with EV and the only one that correlated with variceal size.

Conclusion:the results of our work recommend the application of the “platelet count/ spleen diameter ratio strategy” for endoscopic screening of cirrhotic patients for EV, which seems to be more cost effective than the “scope all strategy”.