Clinical, endoscopic and ultrasonographic findings in portal hypertension of different causes

ABSTRACT

Fifty six patients were divided according to careful history, thorough clinical examination, laboratory, endoscopic and abdominal ultrasonographic findings into 4 groups. Group I included 13 patients with liver discase with no evidence of portal hypertension and they were considered as a control for the other groups. Group II comprised 17 patients with bilharzial hepatospenomegaly. Group III included 13 posthepatitic cases. Group IV comprised 13 mixed schistosomal and posthepatitic cases. Endoscopic examination revealed osophageal varices in 0%, 71%, 46% and 62% of the 4 groups respectively. Abdominal ultrasonography showed a significant increase of the diameters of the portal, splenic and superior mesenteric veins in all groups when compared to group I. Coronary vein more than 4 mm diameter was found in 0%, 18%, 0%, and 16%, umbilical collaterals were visualized in 0%, 6%, 8% and 0% and lienorenal collaterals in 0%, 12%, 16% and 8% of the 4 groups respectively. It was concluded, therefore, that the ultrasonographic visualization of portal splenic, superior mesenteric and coronary veins and also umbilical and lienorenal collaterals is a sensitive indicator of portal hypertension