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 in schistosomiasis'.
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 [1].
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 [1] 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 [1].
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.
