Portal hypertension: monocentric retrospective study of 387 cases and review of the literature

Abstract

The portal hypertension is one of the major complications of cirrhosis. It causes hemorrhages by rupture of oesophageal varices and contributes to the development of ascites and hepatic encephalopathy. This is a retrospective study collecting 387 cases of portal hypertension diagnosed at the service of Hepato-gastroenterology of Mohamed VI University Hospital of Marrakech between January 2014 and December 2018.The purpose of this work is to determine the epidemiological aspects, clinico -biological, radiological, endoscopic and therapeutic of portal hypertension and its complications. The average age was 51.3years, the sex ratio M/F was 0.8. Portal hypertension was revealed by haemorrhagic decompensation in 48.8% of cases, ascitic decompensation in 53.2% of cases, splenomegaly in 47.8% of cases, jaundice in 27.13% of cases, and hepatic encephalopathy in 8.52% of cases. Almost half of the cirrhotic patients were classified as child B. Upper digestive endoscopy objectified esophageal varices in the majority of patients, gastric varices in almost one-third of cases. Cirrhosis was the most common etiology of portal hypertension in 86.82%, cirrhosis post viral was reported in 28.57% of cases. The alcoholic origin of cirrhosis was objectified in only 5.76% of cases. Nearly two-thirds of patients had ascitic decompensation, half of them haemorrhagic decompensation and 11.6% had hepatic encephalopathy. Hepatic hydrothorax was observed in 9.81% of cases, and hepatocellular carcinoma in 6.20% (n=24) of cases.