Cirrhotic Patients; Frequency and Pattern of Gastric Vascular Changes

Abstract

At present time portal hypertension is perceived as one of the complications of advanced liver disease. It results in various vascular changes in gastrointestinal tract (GI), including esophageal varices, gastric varices and portal hypertensive gastropathy (PHG). PHG and gastric varices are a common cause of acute as well as chronic bleeding from GI tract which resulted in significant mortality among patients. Objectives: To determine the frequency of gastric vascular changes in various causes of cirrhosis. Patients of age ≥30 years, with clinical evidence of cirrhosis and without prior treatment of esophagiogastric varices were included in the study. Results: A total of 100 patients were enrolled in the study out of which 47 were male and 53 were females with mean age of 53.6 years. The most common type of cirrhosis was turned out to be Hepatitis C affecting 50% of patients and most of the patients were in Child class C. Portal hypertensive gastropathy was present in 74% of patients. Among them 24.3% have mild changes while severe changes were present in75.7% of patients. Gastric varices were found in 40% of the patients and the most common type was IGV type I which was present in 29(72.5%) of the patients. Correlation of severity of PHG was seen with grading of esophageal varices, grading of gastric varices and Child class. Conclusion: Frequency of severe gastropathy is higher than the mild gastropathy. It is also concluded that gastric vascular changes are associated with cause of cirrhosis, child class and degree of portal hypertension.

The Spectrum of Oesophagal Varices, Portal Hypertensive Gastropathy and Child Pugh’s Class in Cirrhotic Patients at Tertiary CareHospital

“…[13][14][15] Our study has demonstrated that as liver dysfunction progresses to higher child Pugh's Class (Class-C),the tendency of varices formation & bleeding also rises; similar observations have been documented by previous studies. 16,17 It was found that liver dysfunction and complications of liver cirrhosis (Child-Pugh Class-B 82%, Child-Pugh Class C 87%) were more common in middle age and elderly patients between 40-80 years. This group of patients was more commonly seen in the Emergency Department with hematemesis, which may mean that older age is associated with higher Child Pugh's Class and formation of large oesophagal varices and increased bleeding tendency, where this may be due to the chronicity of disease itself.…”