RESUMO
La hipertensión porta (HTP) es el resultado del incremento de la presión dentro del sistema venoso porta. Se presenta con poca frecuencia en el paciente pediátrico pero es una de las mayores causas de morbilidad y mortalidad en el niño con enfermedad hepática. La mayoría de los pacientes con http presentan un estado hiperdinámico, lo cual aumenta el flujo venoso porta y mantiene la hipertensión. Puede ser secundaria a obstrucción a nivel prehepático, intrahepático o extrahehepático.
Portal hypertension (PH) is the result of increased pressure within the portal venous system. It occurs infrequently in the pediatric patient but it is a major cause of morbidity and mortality in children with liver disease. Most patients with PH have a hyperdynamic state, which increases venous flow and portal hypertension remains. May be secondary to obstruction at prehepatic, intrahepatic or extrahehepatic.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Ascite/classificação , Esplenomegalia/classificação , Esplenomegalia/complicações , Hematemese/mortalidade , Hematemese/sangue , Hipertensão Portal/epidemiologia , Hipertensão Portal/mortalidade , Hipertensão Portal/patologia , Degeneração Hepatolenticular/classificação , Degeneração Hepatolenticular/diagnóstico , Fibrose Cística/classificação , Transtornos da Nutrição Infantil/etiologia , Transtornos da Nutrição Infantil/genética , Transtornos da Nutrição Infantil/mortalidade , Transtornos da Nutrição Infantil/sangueRESUMO
To determine the correlation of ABRI with treatment intervention and outcome as discharged or expired in patients of acute variceal bleed. Cross-sectional study Records of all the patients admitted in Medical Unit-IV, Civil Hospital Karachi with acute variceal bleeding during January 2004 to October 2006 were retrieved. Use of vasoactive agents [Terlipressin/Octreotide], endoscopic band ligation [EBL] and outcome [Discharged/Expired] were noted. ABRI was calculated by the following formula: ABRI= Blood Units Transfused/ [[Final Hematocrit - Initial Hematocrit] + 0.01] Mean ABRI were compared by Student's 't' test according to vasoactive therapy, EBL and outcome. Correlation of ABRI with the same variables was also studied by plotting Receiver Operative Curves [ROC]. Seventy six patients fulfilling inclusion criteria were selected. No statistically significant difference was observed in the mean ABRI scores when compared according to vasoactive drug administration, EBL and outcome. Significant correlation with mortality was seen on ROC plot with significantly larger area under the curve. ABRI correlated significantly with mortality in this study. Larger prospective studies with appropriate power are required to evaluate its association with other variables
Assuntos
Humanos , Varizes Esofágicas e Gástricas/mortalidade , Hematemese/terapia , Hematemese/mortalidade , Resultado do Tratamento , Estudos Transversais , Transfusão de Sangue , Hematócrito , Lipressina/análogos & derivados , Octreotida , Hemostase Endoscópica , Hipertensão Portal , Doença Aguda , Hemorragia GastrointestinalRESUMO
On 30.08.2003, a 20-year-old boy met with a vehicular accident and sustained spinal injury and left upper limb fracture. He was immediately hospitalized and seemed to recover well after treatment for a period of 15 days, when just before discharge he suddenly had hematemesis and bleeding per rectum and succumbed within another 24 hours. The case is discussed in detail.