title: Surgical management of bleeding esopageal varices: the Tikur Anbessa hospital experience.
abstract: Surgery is one of the modalities of treatment of portal hypertension with bleeding esophageal varices. Between 1992 and 2003, a total of 33 patients with esophageal varices secondary to hepatic or pre-hepatic causes of portal hypertension underwent proto-azygeal disconnection surgery at Tikur Anbessa Hospital, Addis Ababa University. Twenty-five, (69. 7%) were men and 8 (24.3%) were women. Their age ranged between 13 and 54 years with a mean age of 24.3 years. Eighty two percent of the patients had hematemesis and melena. Thirty-two, (97%) patients had splenomegaly and of these; 27 (84%) had splenomegaqly with hyperslenism. Twenty-one, (63.6%) and 12 (36.6%) patients had child's A and B functional class, respectively. None of the patients was in class C. The condition of the liver as assessed macroscopically at surgery showed portal fibrosis in 22 (66.7%), cirrhosis in 3 (9.1%) and normal liver in 8 (24.2%) patients. There was no significant correlation between variceal bleeding episode and type of liver pathology. Four patients (12%) died after surgery and re-bleeding occurred in one (3%) patients. Porto-azygeal disconnection surgery can be done safely in patients with esophageal varices and good liver function in order to prevent further bleeding episode.
authors.affiliation: Department of Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.
authors.forename: Endale
authors.initials: E
authors.lastname: Kassa
authors.forename: Orval
authors.initials: O
authors.lastname: Jhonson
mesh_terms: D000293:Adolescent; D000328:Adult; D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000601:surgery*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013163:Splenomegaly / Q000453:epidemiology; D016896:Treatment Outcome