Study of risk factor for variceal bleeding in schistosomal hepatic fibrosis patients

ABSTRACT

One hundred and twenty patients with schistosomal hepatic fibrosis and esophageal varices [mean age 34.6 + 10.6] were divided into three groups. Group I included 55 patients with past history of esophageal variceal bleeding episode [s], group II entailed 50 patients with no previous history of bleeding, and group III comprised 15 patients previously submitted to decongestion operation. 30 patients out of the group II were submitted to prophylactic sclerotherapy. Variceal bleeding occurred in 30% of the rest of this group. All patients were followed up for a mean period of 14 +/- 3.2 months [range between 8-21 months]. The most significant risk factors for occurrence of first or recurrent variceal bleeding were; increased age; low prothrombin activity, decreased platelet count, and also high modified Child's score especially in patients with past history of recurrent bleeding. Endoscopically detected factors included, large sized blue varices, with positive red color sign which was found in 90% of patients with recurrent bleeding; and in 100% of patients who bled for the first time during the study period. Increased umbilical vein diameter measured ultrasonographically was found to be an important risk factors in first time bleeders