Variceal BleedingNCT07571876
Ultrasound Prediction of Esophageal Variceal Bleeding Risk
An observational study of Variceal Bleeding and Ultrasonography, run by Assiut University.
Trial summary
This prospective observational study aims to evaluate the accuracy of using routine abdominal ultrasound to predict the risk of esophageal variceal bleeding in adult patients with liver cirrhosis. Esophageal variceal bleeding is a serious complication of chronic liver disease. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Variceal Bleeding, Ultrasonography, Esophageal Bleeding
- How many people
- 165 participants
- Where
- No sites listed yet
- Study dates
- Apr 2026to May 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: Adult patients (aged 18 years and older) with chronic liver disease and established liver cirrhosis (including both compensated and decompensated, Child-Pugh classes A, B, and C) who are scheduled for an upper gastrointestinal endoscopy at AL-Rajhi University Hospital, Assiut University, Egypt.
Who may be able to join
- Adult patients (age ≥18 years) with chronic liver disease and clinical/laboratory/radiological evidence of liver cirrhosis
- Both compensated and decompensated cirrhosis (Child-Pugh classes A, B, and C)
- Patients scheduled for upper gastrointestinal endoscopy
- Patients who provide informed consent
Who cannot join
- Previous history of endoscopic variceal band ligation or sclerotherapy
- Prior surgical portosystemic shunt procedures or transjugular intrahepatic portosystemic shunt (TIPS)
- Hepatocellular carcinoma with portal vein thrombosis
- Previous splenectomy
- Patients receiving beta-blockers for variceal bleeding prophylaxis
- Poor quality ultrasound images due to obesity or ascites
- Refusal to participate in the study
About this study
Official title: Splenic Size and Portal Vein Diameter on Ultrasound in Predicting Esophageal Variceal Bleeding Risk
This prospective observational study aims to evaluate the accuracy of using routine abdominal ultrasound to predict the risk of esophageal variceal bleeding in adult patients with liver cirrhosis. Esophageal variceal bleeding is a serious complication of chronic liver disease. While upper gastrointestinal endoscopy is the current standard for diagnosing and grading these varices, it is an invasive procedure.
In this study, researchers will use ultrasound to measure the patient's spleen size and portal vein diameter. These non-invasive measurements will then be compared to the results of a standard upper endoscopy performed within 48 to 72 hours. The goal is to determine if these simple ultrasound measurements can reliably predict the presence, grade, and bleeding risk of esophageal varices, which could potentially reduce the need for routine invasive endoscopic screenings in the future.
Read the detailed description
Background and Rationale:
Esophageal variceal bleeding is a life-threatening complication of portal hypertension in patients with chronic liver disease. While upper gastrointestinal endoscopy remains the gold standard for diagnosing and grading esophageal varices, it is an invasive procedure. Recent studies demonstrate that non-invasive parameters, specifically ultrasonographic measurements like portal vein diameter and splenic size, have emerged as independent predictors of variceal presence and bleeding risk. Despite these findings, there is limited data from Egyptian populations, particularly from Upper Egypt. This study aims to assess the diagnostic accuracy of these measurements and establish optimal cutoff values for non-invasive parameters in this population.
Study Design and Setting:
This is a prospective cross-sectional observational study conducted at the Department of Tropical Medicine and Gastroenterology and the Department of Diagnostic Radiology at AL-Rajhi University Hospital, Assiut University, Egypt. The study aims to recruit 165 adult patients with liver cirrhosis.
Study Procedures:
All enrolled participants will undergo the following assessments:
Clinical and Laboratory Assessment: Participants will undergo comprehensive history taking and physical examinations, alongside the calculation of Child-Pugh and Model for End-Stage Liver Disease (MELD) scores. Blood samples will be evaluated for complete blood count (focusing on platelets), liver and renal function tests, and prothrombin time/INR.
Abdominal Ultrasound: A high-resolution ultrasound using a 3.5-5 MHz convex transducer will be performed to measure the longest craniocaudal splenic diameter, splenic width and thickness, and portal vein diameter at the porta hepatis. Additional assessments include splenic vein diameter, ascites, liver echotexture, and the calculation of the platelet count/spleen diameter ratio.
Upper Gastrointestinal Endoscopy: Within 48-72 hours of the ultrasound, an endoscopy will be performed. Investigators will grade the varices (Grade I-III), assess for red color signs (indicating high bleeding risk), and document any gastric varices or portal hypertensive gastropathy.
- Conditions
- Variceal Bleeding, Ultrasonography, Esophageal Bleeding, Esophageal Varices, Liver Cirrhosis, Portal Hypertension
- Keywords
- portal vein diameter, splenic size, ultrasound, esophageal variceal bleeding risk
- Medical subject headings
- Esophageal and Gastric Varices, Liver Cirrhosis, Hypertension, Portal
What is being measured
The primary outcome is the main question the study is designed to answer.
Grade of esophageal varices
Assessed during upper gastrointestinal endoscopy and classified according to the General Rules for Recording Endoscopic Findings: Grade I (small, straight varices), Grade II (enlarged, tortuous varices occupying <1/3 of lumen), and Grade III (large, coil-shaped varices occupying >1/3 of lumen).
Measured: Baseline (at the time of upper gastrointestinal endoscopy, performed within 48 to 72 hours of the ultrasound examination)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2026
- Study startApr 2026 (estimated)
- Primary completionApr 2027 (estimated)
- Study completionMay 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Variceal BleedingStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 165 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mireille Maged Emile Hanna, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07571876
- Sponsor's protocol ID
- Esophageal Variceal Bleeding
- Status last verified
- May 2026
- First submitted
- 4 Mar 2026
- Last updated
- 6 May 2026
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Splenic Size and Portal Vein Diameter on Ultrasound in Predicting Esophageal Variceal Bleeding Risk
- ClinicalTrials.gov ID
- NCT07571876
- Acronym / sponsor ID
- Esophageal Variceal Bleeding
- Conditions
- Variceal Bleeding, Ultrasonography, Esophageal Bleeding, Esophageal Varices, Liver Cirrhosis, Portal Hypertension
- Keywords
- portal vein diameter, splenic size, ultrasound, esophageal variceal bleeding risk
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 165 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- Apr 2026 (estimated)
- Primary completion
- Apr 2027 (estimated)
- Study completion
- May 2027 (estimated)
- First posted
- 6 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This prospective observational study aims to evaluate the accuracy of using routine abdominal ultrasound to predict the risk of esophageal variceal bleeding in adult patients with liver cirrhosis. Esophageal variceal bleeding is a serious complication of chronic liver disease. While upper gastrointestinal endoscopy is the current standard for diagnosing and grading these varices, it is an invasive procedure.
In this study, researchers will use ultrasound to measure the patient's spleen size and portal vein diameter. These non-invasive measurements will then be compared to the results of a standard upper endoscopy performed within 48 to 72 hours. The goal is to determine if these simple ultrasound measurements can reliably predict the presence, grade, and bleeding risk of esophageal varices, which could potentially reduce the need for routine invasive endoscopic screenings in the future.
Detailed description
Background and Rationale:
Esophageal variceal bleeding is a life-threatening complication of portal hypertension in patients with chronic liver disease. While upper gastrointestinal endoscopy remains the gold standard for diagnosing and grading esophageal varices, it is an invasive procedure. Recent studies demonstrate that non-invasive parameters, specifically ultrasonographic measurements like portal vein diameter and splenic size, have emerged as independent predictors of variceal presence and bleeding risk. Despite these findings, there is limited data from Egyptian populations, particularly from Upper Egypt. This study aims to assess the diagnostic accuracy of these measurements and establish optimal cutoff values for non-invasive parameters in this population.
Study Design and Setting:
This is a prospective cross-sectional observational study conducted at the Department of Tropical Medicine and Gastroenterology and the Department of Diagnostic Radiology at AL-Rajhi University Hospital, Assiut University, Egypt. The study aims to recruit 165 adult patients with liver cirrhosis.
Study Procedures:
All enrolled participants will undergo the following assessments:
Clinical and Laboratory Assessment: Participants will undergo comprehensive history taking and physical examinations, alongside the calculation of Child-Pugh and Model for End-Stage Liver Disease (MELD) scores. Blood samples will be evaluated for complete blood count (focusing on platelets), liver and renal function tests, and prothrombin time/INR.
Abdominal Ultrasound: A high-resolution ultrasound using a 3.5-5 MHz convex transducer will be performed to measure the longest craniocaudal splenic diameter, splenic width and thickness, and portal vein diameter at the porta hepatis. Additional assessments include splenic vein diameter, ascites, liver echotexture, and the calculation of the platelet count/spleen diameter ratio.
Upper Gastrointestinal Endoscopy: Within 48-72 hours of the ultrasound, an endoscopy will be performed. Investigators will grade the varices (Grade I-III), assess for red color signs (indicating high bleeding risk), and document any gastric varices or portal hypertensive gastropathy.
Study design
- Observational model
- Cohort
- Time perspective
- Cross-sectional
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- Adult patients (aged 18 years and older) with chronic liver disease and established liver cirrhosis (including both compensated and decompensated, Child-Pugh classes A, B, and C) who are scheduled for an upper gastrointestinal endoscopy at AL-Rajhi University Hospital, Assiut University, Egypt.
Key inclusion criteria (4 listed)
- Adult patients (age ≥18 years) with chronic liver disease and clinical/laboratory/radiological evidence of liver cirrhosis
- Both compensated and decompensated cirrhosis (Child-Pugh classes A, B, and C)
- Patients scheduled for upper gastrointestinal endoscopy
- Patients who provide informed consent
Key exclusion criteria (7 listed)
- Previous history of endoscopic variceal band ligation or sclerotherapy
- Prior surgical portosystemic shunt procedures or transjugular intrahepatic portosystemic shunt (TIPS)
- Hepatocellular carcinoma with portal vein thrombosis
- Previous splenectomy
- Patients receiving beta-blockers for variceal bleeding prophylaxis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Grade of esophageal varices
Time frame: Baseline (at the time of upper gastrointestinal endoscopy, performed within 48 to 72 hours of the ultrasound examination)
Assessed during upper gastrointestinal endoscopy and classified according to the General Rules for Recording Endoscopic Findings: Grade I (small, straight varices), Grade II (enlarged, tortuous varices occupying <1/3 of lumen), and Grade III (large, coil-shaped varices occupying >1/3 of lumen).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Variceal Bleeding and Ultrasonography, run by Assiut University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Grade of esophageal varices (time frame: Baseline (at the time of upper gastrointestinal endoscopy, performed within 48 to 72 hours of the ultrasound examination)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.