Study of the fibrinolytic activity of gastric secretion in schistosomal hepatic fibrosis and its relation to hematemesis

ABSTRACT

Hematemesis due to rupture of gastro-esophageal varices is a common and serious problem in patients with schistosomal hepatic fibrosis. Factors that may lead to or augment this are still controversial. This work aimed at studying the fibrinolytic activity of gastric juice as a guide to its possible role in initiating or perpetuation bleeding in these patients. Thirty male patients with pure schistosomal hepatic fibrosis and gastro-esophageal varices were studied divided into two equal groups. One group had a history of repeated bleeding from these varices while the other had not such a history. Another 10 healthy male subjects were included as a control group. Gastric secretion of all subjects was examined for the presence of fibrin degradation products [FDPs] and is capability to shorten euglobulin clot lysis time [ECLT] of plasma of the same subject. FDPs were detected only in the two groups of patients with higher degree of positivity in the bleeding group. With gastric secretion ECLT was significantly shortened in bleeding group and ECLT in both groups of patients was significantly shorter than that of the control group. These results confirmed the presence of fibrinolytic activity in gastric secretion that is more evident in patients with tendency to bleeding from gastro-esophageal varices