Portal hypertension (PH) and bleeding oesophageal varices
is the most common clinical presentation or complication of CHF.
About 50% of children with EHPVO present with bleeding from oesophageal varices
. (1-3) Improvements in the management of children with intrahepatic disease have led to increased survival, consequently contributing to the long-term burden of portal hypertension.
His supervisor was Bert Myburgh, and the thesis was entitled 'The effect of distal splenorenal shunting on hepatic perfusion and function of patients with bleeding oesophageal varices
They are swollen, irregularly shaped, twisted and distorted veins which most commonly occur in the legs but can happen elsewhere, such as the lower end of the gullet (oesophageal varices
) and in veins from the testicles (varicocoele).
Conclusion: The presence of an enlarged spleen is a valid predictor of the presence of oesophageal varices
in patients suffering with liver cirrhosis.
When the portal vein pressure increases to a certain degree, oesophageal varices
can occur, while, in severe cases, oesophageal variceal bleeding will emerge, which is the most common and severe complication of cirrhosis and cirrhotic portal hypertension, as well as the most common cause of death for cirrhosis .
It is defined as elevation of hepatic venous pressure gradient more than 5 mmHg and is caused by increased intrahepatic resistance to blood flow due to loss of liver architecture in cirrhosis which ultimately leads to splenomegaly, ascites and oesophageal varices
. Dib et al  showed oesophageal varices
were developed when portal vein diameter exceeds 13 mm.
Non-invasive Diagnosis of Oesophageal Varices
Using Systemic Haemodynamic Measurements by Finometry: Comparison with Other Non-invasive Predictive Scores.
A study that assessed 78 cirrhotic patients without oesophageal varices
(EV) using oesophageal manometry and simultaneous 24hour pH study reported increased frequency of abnormal reflux episodes (55%) and reflux oesophagitis (37%) compared to 30 healthy controls .
The presence of ascites and oesophageal varices
were determined at admission and on subsequent visits.
(4,9) There is consensus that assessment of intervention efficacy in cirrhotic patients with portal hypertension and bleeding oesophageal varices
should be based on the control of bleeding and the risks of rebleeding and death as the 3 major outcomes.
Bleeding from oesophageal varices
is the most serious complication of portal hypertension and accounts for most cirrhosis-related deaths.