Predictors of Bleeding of Esophageal Varices Among Patients with Portal Hypertension-Sudan
American Journal of Biomedical and Life Sciences
Volume 4, Issue 6, December 2016, Pages: 103-106
Received: Oct. 23, 2016; Accepted: Dec. 17, 2016; Published: Dec. 20, 2016
Views 1997      Downloads 103
Authors
Hyder Osman Mirghani, Medical Department, Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Hamza Khamees, Medical Department, Faculty of Medicine, Khartoum University, Khartoum, Sudan
Article Tools
Follow on us
Abstract
Esophageal varices develop in more than one third in patients with liver cirrhosis with a high rate of mortality due to bleeding, We aimed to study predictors of bleeding in esophageal varices in Sudan. This retrospective cross-sectional study conducted at the National Gastrointestinal bleeding Center in Sudan, during the period March-September 2007. The record of 236 patients with bleeding esophageal varices was reviewed for: Demographic data, the presence of jaundice, fever, ascites, splenomegaly, and splenectomy full blood count, liver function tests, ultrasonographic report, endoscopic finding. Ethical clearance was obtained from both ethical committees of Sudan Medical Specialization Board, and the National Gastrointestinal bleeding Center. Out of 236 patients their age ranged from 18-79 years with a mean of 52.1±14.3, male dominance was apparent (80%). The majority were from Gazera region (62.3%). Splenomegaly, thrombocytopenia, and raised prothrombin time were found to predict esophageal variceal bleeding P-value <0.05, while fever and splenectomy were not P-value > 0.05. Splenomegaly, thrombocytopenia, and raised prothrombin time were predictors of bleeding in esophageal varices.
Keywords
Predictors, Bleeding, Varices, Sudan
To cite this article
Hyder Osman Mirghani, Hamza Khamees, Predictors of Bleeding of Esophageal Varices Among Patients with Portal Hypertension-Sudan, American Journal of Biomedical and Life Sciences. Vol. 4, No. 6, 2016, pp. 103-106. doi: 10.11648/j.ajbls.20160406.14
Copyright
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Pagliaro L, D’Amico G, Pasta L, Politi F, Vizzini G, Traina M, et al. Portal hypertension in cirrhosis: Natural history. In: Bosch J, Groszmann RJ, editors. Portal Hypertension. Pathophysiology and Treatment. Oxford: Blackwell Scientific; 1994. pp. 72–92.
[2]
Groszmann RJ, Garcia-Tsao G, Bosch J, Grace ND, Burroughs AK, Planas R, et al. Beta-blockers to prevent gastroesophagealvarices in patients with cirrhosis. N Engl J Med. 2005; 353: 225.
[3]
D’Amico G, De Franchis R. Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators. Hepatology. 2003; 38: 599–612.
[4]
Carbonell N, Pauwels A, Serfaty L, Fourdon O, Levy VG, Poupon R. Improved survival after variceal bleeding in patients with cirrhosis over the past two decades. Hepatology. 2004; 40: 652–9.
[5]
García-Pagán JC, Gracia-Sancho J, Bosch J. Functional aspects on the pathophysiology of portal hypertension in cirrhosis. J Hepatol 2012; 57: 458.
[6]
Berzigotti A, Seijo S, Reverter E, Bosch J. Assessing portal hypertension in liver diseases. Expert Rev GastroenterolHepatol 2013; 7: 141.
[7]
de Franchis R, Primignani M. Natural history of portal hypertension in patients with cirrhosis. Clin Liver Dis. 2001 Aug; 5 (3): 645-63.
[8]
Humaida S, EL Gaddal AA, Homeida MM. Schistosomiasis: epidemiology and burden of disease in the Sudan. Sudan Med J 2011 August; 47 (2): 63-68.
[9]
Groszmann RJ, Wongcharatrawee S. The hepatic venous pressure gradient: anything worth doing should be done right. Hepatology 2004; 39: 280.
[10]
Pinzani M, Rosselli M, Zuckermann M. Liver cirrhosis. Best Pract Res ClinGastroenterol 2011; 25: 281.
[11]
Manohar TP, Patil V, Salkar HR. Combination of non-endoscopic parameters as predictors of large esophageal varices. Trop Gastroenterol. 2014 Jul-Sep; 35 (3): 173-9.
[12]
Chofle AA, Jaka H, Koy M, Smart LR, Kabangila R, Ewings FM, Mazigo HD, Johnson WD Jr, Fitzgerald DW, Peck RN, Downs JA. Oesophageal varices, schistosomiasis, and mortality among patients admitted with haematemesis in Mwanza, Tanzania: a prospective cohort study. BMC Infect Dis. 2014 Jun 3; 14: 303. doi: 10.1186/1471-2334-14-303
[13]
Eltoum IA, Taha TE, Saad AM, Suliman SM, Bennett JL, Nash TE, Homeida MM. Predictors of upper gastrointestinal bleeding in patients with schistosomal periportal fibrosis. Br J Surg. 1994 Jul; 81 (7): 996-9.
[14]
Amarapurkar DN, Parikh SS, Shankaran K, Chopra K, Dhawan P, Kalro RH, et al. Correlation between splenomegaly and oesophageal var ices in patients with liver cirrhosis. Endoscopy. 1994; 26:
[15]
Chalasani N, Imperiale TF, Ismail A, Sood G, Carey M, Wilcox CM, et al. Predictors of large esophageal varices in patients with cirrhosis. Am J Gastroenterol. 1999; 94: 3285–91.
[16]
Eltoum IA, Taha TE, Saad MA, Suliman MS, BennettJL, Nash TE, Hommeida MM. Predictors of upper gastrointestinal bleeding in patients with schistosomalperi portal fibrosis. British Journal of Surgery 1994; 81: 996-999.
[17]
Manohar TP, Patil V, Salkar HR. Combination of non-endoscopic parameters as predictors of large esophageal varices. Trop Gastroenterol. 2014 Jul-Sep; 35 (3): 173-9.
[18]
North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med 1988; 319: 983.
[19]
Aquino RT, Chieffi PP, Catunda SM, Araújo MF, Ribeiro MC, Taddeo EF, Rolim EG. Hepatitis B and C virus markers among patients with hepatosplenic mansoni cschistosomiasis. Rev Inst Med Trop Sao Paulo. 2000; 42: 313–320.
[20]
Grace ND. Prevention of initial variceal hemorrhage. GastroenterolClin North Am 1992; 21: 149.
[21]
Vizzutti F, Arena U, Romanelli RG, Rega L, Foschi M, Colagrande S, et al. Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis. Hepatology. 2007; 45: 1290–7.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186