Management of Endoscopic Portal Hypertension Lesions in Cirrhotic Patients in a Country with Limited Resources: About 603 Cases in the City of Douala in Cameroon

Abstract

Introduction: Portal hypertension (HTP) is a morbi-mortality factor in cirrhotic patients. It is responsible for endoscopic lesions and has digestive hemorrhage as the main complication. The objective of the study was to study the management of endoscopic lesions of portal hypertension in a country with limited resources. Methodology: This was a cross-sectional and analytical study conducted in 04 hospitals in the city of Douala, Cameroon, over a period of 08 years from 1 January 2014 to 31 December 2022. Included were cirrhotic patients with viral hepatitis with endoscopic lesions of PH. The data collected were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Data analysis was done using SPSS software version 25.0. Logistic regression allowed the search for prognostic factors with a significance threshold of p < 0.005. Results: We included 603 patient records. They were mainly male patients (56.1%) with an average age of 47.6 ± 6.3 years. The Child Pugh score was ranked B in 53.7% of cases. Digestive hemorrhage was the main complication in 66.8% of cases. We had grade 2 esophageal varices in 61.5% of cases. The main treatments were prescription of propanolol (63.3%) and ligation of esophageal varices (53.3%). The average number of ligation sessions was 2.1 ± 1.8 with an interval between sessions of 28 ± 2.8 days. Prevention of rupture of esophageal varices was secondary in 66.5% of cases (n = 452). The rate of hemorrhagic recurrence was 9.3%. Hospital mortality was 15.