I read with great interest the article by Zaman et al1 on identification of a subgroup of cirrhotic patients requiring endoscopy (low platelet count and advanced Child-Pugh classification criteria).
A perusal of the data, however, presents several interesting observations. Extrapolation of data from Table 1 reveals that 28 of 66 patients (prevalence of 42%) with Child-Pugh class A had either small or large gastric varices, suggesting that approximately 2 of every 5 cirrhotic patients in this category would not be diagnosed to have varices, if endoscopy were to be done in this group.
Ghosh AK. Refusal of Endoscopy in Cirrhotic Patients With Child-Pugh Class A Without Prior Variceal Bleeding: An Internist Dilemma. Arch Intern Med. 2002;162(8):947-948. doi: