DOI: 10.36347/sjams.2019.v07i05.068

Pages: 2027-2034

This cross sectional analytic study was conducted in the department of Pediatrics, Bangabandu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Dhaka Shishu Hospital of Bangladesh for a period from January 2017 to June 2018. The main objective of the study was to evaluate the significance of high SAAG value as a predictor of portal hypertension, manifested by oesophageal varices and low SAAG value as a predictor of absence of portal hypertension. A total of 55 patients were studied. Among them, 31 were chronic liver disease patients with ascites and rest 24 patients were nephrotic syndrome patients with ascites. The mean age of the patients was 8.3±3.6 years. In the study 81% of the patients with chronic liver disease were found to have high SAAG (1.1gm/dl) and 100% of the nephrotic syndrome patients were found to have low SAAG (<1.1gm/dl). Mean SAAG value of patients with chronic liver disease was significantly higher than that of nephrotic syndrome patients. This finding indicates that portal hypertension is the cause of this difference among the two transudative causes of ascites. By upper gastrointestinal endoscopy, oesophageal varices were found in 81% of the high SAAG patients with chronic liver disease whereas oesophageal varices was found only in 17% of low SAAG patients with chronic liver disease. This finding indicates that oesophageal varices are associated with high SAAG value. The mean SAAG value of chronic liver disease patients with oesophageal varices were significantly higher than that of patients with nephrotic syndrome. But the mean SAAG value of both chronic liver disease patients and nephrotic syndrome patients without oesophageal varices were low and no significant difference of SAAG value was found among them. The SAAG value of 1.1 gm/dl will differentiate chronic liver disease with oesophageal varices from those without oesophageal varices. In this study predicting oesophageal variceal sensitivity (76%) was found reasonab