Some predictors of variceal bleeding in patients with bilharzial hepatic fibrosis

ABSTRACT

This work was conducted on 35 patients with schistosomal periportal fibrosis and portal hypertension compared with 10 healthy controls to search for some risk factors associated with variceal bleeding such as endoscopic findings, some vasodilator humoral agents in addition to echo-Doppler flowmetry findings. Full clinical examination and routine laboratory investigations were done. Humoral vasodilators included glucagon, enkephalin and prostaglandin E2 [PGE2]. Upper gastrointestinal endoscopy and echo-Doppler duplex study were done to all cases for evaluation of portal venous hemodynamics, superior mesenteric artery dilatation and coronary vein visualization and/or dilatation. Results showed a biochemical profile of hyperglucagonemia is usually associated with a higher portal pressure, larger variceal diameter and a hyperdynamic splanchnic state and if associated with high enkephalin level, there will be a higher chance of bleeding