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Editor's Correspondence
April 22, 2002

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:

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.

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