CORRELATION BETWEEN SEVERITY OF PORTAL HYPERTENSIVE GASTROPATHY AND SIZE OF OESOPHAGEAL VARICES IN CIRRHOTIC HEPATITIS-C PATIENTS
AbstractBackground: Portal hypertension can lead to oesophageal varices (EV) and portal hypertensive gastropathy (PHG). The aim of this study is to determine the relationship between severity of Portal hypertensive gastropathy and size of oesophageal varices. Methods: One hundred and ninety-five patients of hepatitis C positive chronic liver disease having oesophageal varices were assessed for severity of portal hypertensive gastropathy. Results: Mild Portal Hypertensive Gastropathy was observed in 16 (8.2 %), moderate in 54 (27.7 %) and severe in 120 (61.6 %) patients. Grade 1 Oesophageal Varices were present in 79 (40.5%) patients, grade 2 in 44(21.9%) patients, grade 3 in 62 (31.8%) and grade 4 in 10 (5.2%) patients. No significant correlation was observed between grades of gastropathy and size of varices. Conclusion: The frequency of portal hypertensive gastropathy was 97.5% in Hepatitis C positive cirrhotic patients having oesophageal varices. Severity of gastropathy is not related to the grade or size of oesophageal varices.Keywords: portal hypertensive gastropathy; oesophageal varices; cirrhosis
Schuppan D, Afdhal NH. Liver Cirrhosis. Lancet 2008;371(9615):838–51.
UK national statistics, https://www.gov.uk/government/publications/liver-disease-applying-all-our-health/liver-disease-applying-all-our-health
Biecker E. Portal hypertension and gastrointestinal bleeding: diagnosis, prevention and management. World J Gastroenterol 2013;19(31):5035–50.
Turon F, Casu S, Hernández-Gea V, Garcia-Pagán JC. Variceal and other portal hypertension related bleeding. Best Pract Res Clin Gastroenterol 2013;27(5):649–64.
Triantos C, Kalafateli M. Endoscopic treatment of esophageal varices in patients with liver cirrhosis. World Journal of Gastroenterology : WJG. 2014;20(36):13015-26. doi:10.3748/wjg.v20.i36.13015.
Chung WJ. Management of portal hypertensive gastropathy and other bleeding. Clin Mol Hepatol 2014;20(1):1–5.
Urrunaga NH, Rockey DC. Portal Hypertensive Gastropathy and Colopathy. Clinics in liver disease. 2014;18(2):389-406. doi:10.1016/j.cld.2014.01.008.
Bang CS, Kim HS, Suk KT, Kim SE, Park JW, Park SH, et al. Portal hypertensive gastropathy as a prognostic index in patients with liver cirrhosis. BMC Gastroenterol 2016;16(1):93.
Gjeorgjievski M, Cappell MS. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy. World J Hepatol 2016;8(4):231–62.
Elwakil R, Al Breedy AM, Gabal HH. Effect of endoscopic variceal obliteration by band ligation on portal hypertensive gastro-duodenopathy: endoscopic and pathological study. Hepatol Int 2016;10(6):965–73.
Charan J, Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med 2013;35(2):121–6.
Paquet KJ. Prophylactic endoscopic sclerosing treatment of the esophageal wall in varices-a prospective controlled randomized trial. Endoscopy 1982;14(1):4–5.
Eleftheriadis E. Portal hypertensive gastropathy. Ann Gastroenterol 2001;14(3):196–204.
Biecker E. Gastrointestinal Bleeding in Cirrhotic Patients with Portal Hypertension. ISRN Hepatol 2013;2013:541836.
Northern 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 multi-center study. N Engl J Med 1988;319(15):983–9.
Fontana RJ, Sanyal AJ, Ghany MG, Bonkovsky HL, Morgan TR, Litman HJ, et al. Development and progression of portal hypertensive gastropathy in patients with chronic hepatitis C. Am J Gastroenterol 2011;106(5):884–93.
Abbasi A, Bhutto AR, Butt N, Munir SM, Dhillo AK. Frequency of portal hypertensive gastropathy and its relationship with biochemical, haematological and endoscopic features in cirrhosis. J Coll Physicians Surg Pak 2011;21(12):723–6.
Ahmed S, Mumtaz K, Ahmed US, Shah HA, Abid S, Hamid S, et al. Frequency and characteristic features of portal hypertensive gastropathy in patients with viral cirrhosis. J Coll Physicians Surg Pak 2010;20(11):714–8.
Sarwar S, Khan AA, Alam A, Butt AK, Shafqat F, Malik K, et al. Effect of band ligation on portal hypertensive gastropathy and development of fundal varices. J Ayub Med Coll Abbottabad 2006;18(1):32–5.
SY. Portal hypertensive gastropathy and its interrelated factors. Hepatobiliary Pancreat Dis Int 2003;2(2):226–9.
Bellis L, Nicodemo S, Galossi A, Guarisco R, Spilabotti L, Durola L, et al. Hepatic venous pressure gradient does not correlate with the presence and the severity of portal hypertensive gastropathy in patients with liver cirrhosis. J Gastrointestin Liver Dis 2007;16(3):273–7.
Safwat E, Hussein HA, Hakim SA. Helicobacter pylori in Egyptian patients with HCV-related liver cirrhosis and portal hypertensive gastropathy: Prevalence and relation to disease severity. Life Sci J 2015;12(3):168–73.
Gupta R, Saraswat VA, Kumar M, Naik SR, Pandey R. Frequency and factors influencing portal hypertensive gastropathy and duodenopathy in cirrhotic portal hypertension. J Gastroenterol Hepatol 1996;11(8):728–33.
Pan WD, Xun RY, Chen YM. Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors. Hepatobiliary Pancereat Dis Int 2002;1(4):527–31.
Fontana RJ, Sanyal AJ, Mehta S, Doherty MC, Neuschwander-Tetri BA, Everson GT, et al. Portal hypertensive gastropathy in chronic hepatitis C patients with bridging fibrosis and compensated cirrhosis: results from the HALT-C trial. Am J Gastroenterol 2006;101(5):983–92.
Primignani M, Carpinelli L, Preatoni P, Battaglia G, Carta A, Prada A, et al. Natural history of portal hypertensive gastropathy in patients with liver cirrhosis. The new italin endoscopic club for the study and treatment of esophageal varices (NIEC). Gastroenterology 2000;119(1):181–7.
Kumar A, Mishra SR, Sharma P, Sharma BC, Sarin SK. Clinical, laboratory, and hemodynamic parameters in portal hypertensive gastropathy: a study of 254 cirrhotics. J Clin Gastroenterol 2010;44(4):294–300.
Zardi EM, Uwechie V, Gentilucci UV, Dobrina A, Petitti T, Laghi V, et al. Portal diameter in the diagnosis of esophageal varices in 266 cirrhotic patients: which role? Ultrasound Med Biol 2007;33(4):506–11.
Wu Q, Shen L, Chu J, Ma X, Jin B, Meng F, et al. Characterization of uncommon portosystemic collateral circulations in patients with hepatic cirrhosis. Oncol Lett 2015;9(1):347–50.
Sarin SK, Sreenivas DV, Lahoti D, Saraya A. Factors influencing development of portal hypertensive gastropathy in patients with portal hypertension. Gastroenterology 1992;102(3):994–9.