Peptic ulcer in chronic liver disease patients: a novel approach

ABSTRACT

The study here reported comprised 30 patients with peptic ulcer, 20 of them were also suffering from chronic liver disease [CLD] with portal hypertension. All patients were attending Benha and Ain Shams Universities' Hospitals seeking medical intervension for their illness. Portal haemodynamic study using the Duplex Dppler sonography [DDS] with colour flow mapping revealed that the basal portal flow velocity and volume, rather than the portal vein calibre alone, are the fundamental predictors of portal hypertension. Moreover, after a standard meal, a significant increase in the basal portal blood flow volume was observed in patients with peptic ulcer alone. Such increase was not significant in patients with chronic hepatitis and almost neglligible in patients with hepatic cirrhosis. It was, therefore, assumed that stasis of blood in the portal circulation would lead to a state of chronic venous congestion refered to as "congestive poartal ischemia" particularly augmented after meals. This pioneering observation is important among other factors contributing to increased frequency and delayed healing of peptic ulcer in patients with chronic liver disease and portal hypertension