RESUMO
To determine the risk factors for bleeding from asymptomatic varices secondary to schistosomal portal hypertension. This is a retrospective, prospective, longitudinal, hospital, based study in a specialised portal hypertension clinic. Clinical, biochemical, haematological, endoscopic and sonographic evaluation were performed. Data was collected prospectively in a special portal hypertension folder designed for the purpose. 141 patients, 104 males and 37 females with an age range of 12 to 72 years [mean 33.7 +/- 13.7] were studied. They were followed-up for a minimum of 1 year and a maximum of 6 years [mean 27.6 months]. 21 patients [14.9%] bled from their varices. 11 patients [7.8%] bled within one year and 10 within the subsequent 6 years. The interval between presentation and bleeding ranged from 4 days to 78 months [mean 19.9 +/- 21.6]. Of the 21 who bled, 3 rebled [14.3%] within 1 year. The bleeders had significantly longer duration of schistosomiasis [p <0.05], more serum bilirubin above 2mg% [p<0.01], more thrombocytopenia [p <0.05], more grade III and IV varices [p <0.05] and more grade III periportal fibrosis [p <0.01]. It is suggested that patients with these risk factors should be considered for close follow-up and medical treatment
RESUMO
We investigated the indications for and findings of gastrointestinal [GI] endoscopy in all children = 16 years old referred for the procedure to the endoscopy unit at Soba University Hospital, Khartoum from January 2004 to January 2006. Thus 113 children were enrolled; 73% underwent upper GI endoscopy, 27% lower GI endoscopy [15% colonoscopy, 12% flexible sigmoidoscopy]. Indications for upper GI endoscopy included haematemesis [24%], portal hypertension [21%], abdominal pain [16%] and vomiting [15%]. Diagnoses included oesophageal varices [16%], gastritis [7%] and hiatus hernia [6%]. Indications for lower GI endoscopy included rectal bleeding [87%], diarrhoea [19%] and anaemia [10%]