[The clinical course of portal hypertensive gastropathy after ligation of esophageal varicose veins].
Portal hypertensive gastropathy (PHG) is a pathological process in the gastric mucosa (GM) that develops due to portal hypertension (PH) and bears a high risk of hemorrhage. Eradication of esophageal varicose veins (EVV) is one of important factors influencing the course of PHG. The purpose of this study was to investigate the course of PHG after eradication of EVV in patients with hepatic cirrhosis (HC). Fifty-two HC patients (39 men, 13 women, mean age: 56.5 years), who underwent EVV ligation, were included in the study. The number of patients with PHG increased three months after EVV ligation; the severity of EVV also increased. The course of PHG differed depending on the time of its onset after surgery. Patients who had not had PHG before EVV ligation developed its signs in 75% of cases. In 31.3% of these patients PHG was resolved, while in 43.6% it did not change during the whole term of observation. In patients who had had PHG before EVV ligation, the latter resolved in 8.3% of cases, became more severe in 33.3% of cases, and remained at the same level in 58.3%. The authors distinguish four types of PHG course. Newly-developed PHG that occurred after EVV eradication, the signs of which remained during the whole period of observation (type I), took place in 13.5% of patients; transient PHG, the signs of which disappeared within three months of observation (type II), was seen in 15.4% of patients; persisting PHG, which was observed before EVV ligation and did not change during the whole study period (type III), was found in 40.3% of patients; progressing PHG, observed before or after EVV ligation and the severity of which grew during the observation period (type IV), was revealed in 23.1% of patients. In 4 (7.7%) of patients PHG signs were absent during the whole time of the study. PHG hemorrhage was observed in 11.5% of the patients. Thus, EVV ligation presents a risk factor of the onset and progression of pre-existing PHG in patients with HC.
Shevchenko
Iu L
IuL
Obukhovskiĭ
B I
BI
Iakovenko
A V
AV
D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013272:Stomach Diseases / Q000209:etiology*; D016896:Treatment Outcome