Journals / Turkish Journal of Gastroenterology / 2012 / Cilt: 23 - Sayı: 3

Alkolik sirozlu hastalarda portal hipertansiyonun non – invaziv değerlendirilmesi

Noninvasive assessment of portal hypertension in patients with alcoholic cirrhosis

Pages
239–246
DOI
—
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusions: Despite the important role of noninvasive markers in providing information pertinent to determination of esophageal varices in patients with liver cirrhosis, these markers have limited relevance in patients with alcoholic cirrhosis.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/aims: Portal hypertension and development of esophageal varices is one of the major complications of liver cirrhosis.
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Key Findings & Data:Material and Methods: We included in our study 86 patients (74 males, mean age 55±7) with alcoholic liver cirrhosis.
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Conclusion & Impact:Conclusions: Despite the important role of noninvasive markers in providing information pertinent to determination of esophageal varices in patients with liver cirrhosis, these markers have limited relevance in patients with alcoholic cirrhosis.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Özofageal ve gastrik varisler · Karaciğer sirozu · alkolik

Abstract

Background/aims: Portal hypertension and development of esophageal varices is one of the major complications of liver cirrhosis. The aim of our study was to evaluate the possibility of the presence of esophageal varices and their size using biochemical and ultrasonography parameters in patients with alcoholic liver cirrhosis. Material and Methods: We included in our study 86 patients (74 males, mean age 55±7) with alcoholic liver cirrhosis. The control group consisted of 102 patients with cirrhosis of other etiologies. All patients underwent a complete biochemical workup, upper digestive endoscopy and ultrasonography examination. The right liver lobe diameter/albumin and platelet count/spleen diameter ratios were calculated. The correlation of the calculated ratios with the presence and degree of esophageal varices in patients with liver cirrhosis was also determined. Results: The mean value of right liver lobe diameter-albumin ratio was 6.15±1.77, and statistically significantly differed from values determined in the control group (4.97±1.68). The mean platelet count-spleen diameter ratio was 972.5±599.0 in alcoholic liver cirrhosis and 1055.9±821.3 in controls (p>0.05). In patients with alcoholic liver cirrhosis, none of the analyzed noninvasive markers was shown to be a good predictor of the presence and size of esophageal varices. Conclusions: Despite the important role of noninvasive markers in providing information pertinent to determination of esophageal varices in patients with liver cirrhosis, these markers have limited relevance in patients with alcoholic cirrhosis.

Özet

Amaç: Portal hipertansiyon ve özofagusta varis gelişimi, karaciğer sirozunun ana komplikasyonlarından birisidir. Çalışmamızın amacı, alkolik karaciğer sirozlu hastalarda özofagus varis varlığı ve boyutlarının, biyokimyasal ve ultrasonografik parametreler kullanılarak öngörülmesidir. Yöntemler: Çalışmaya alkolik karaciğer sirozlu 86 hasta (74 erkek, ortalama yaş 55±7) alındı. Kontrol grubu olarak diğer etyolojilere bağlı 102 siroz hastası alındı. Bütün hastalara tam biyokimyasal çalışma, üst sindirim sistemi endoskopisi ve ultrasonografi uygulandı. Albumin/karaciğer sağ lobu çapı ve trombosit/dalak çapı oranları hesaplandı. Karaci- ğer sirozlu hastalarda hesaplanan oranların özofagus varisi varlığı ve derecesiyle korelasyonu araştırıldı. Bulgular: Ortalama karaciğ er sağ lob çapı – albumin oranı 6,15±1,77 idi ve kontrol grubunda bulunan değer olan 4,97±1,68’den anlamlı şekilde farklıydı. Alkolik karaciğer sirozu hastalarında ortalama 972,5±599,0 olan trombosit sayısı – dalak çapı oranı, kontrollerde 1055,9±821,3 idi (p>0.05). Alkolik karaciğer sirozlu hastalarda analiz edilen non – invaziv belirteçlerin hiçbirisi özofagus varis varlığı ve boyutları açısından prediktif bulunmadı. Sonuçlar: Karaciğer sirozlu hastalarda, non – invaziv belirteçler özofagus varislerinin saptanması na yönelik önemli role sahip olsa da, alkolik sirozda bu rol kısıtlıdır.

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Cite This Article

ALEMPIJEVIC, T., SOKIC-MILUTINOVIC, A., MILICIC, B., JESIC, R., BALOVIC, A., POPOVIC, D., KRSTIC, M. (2012). Alkolik sirozlu hastalarda portal hipertansiyonun non – invaziv değerlendirilmesi. Turkish Journal of Gastroenterology, Cilt: 23 - Sayı: 3, 239–246. https://ajindex.com/articles/409677

References (14)

  1. Christensen E, Fauerholdt L, Schlichting P, et al. Aspects of natural history of gastrointestinal bleeding in cirrhosis and the effect of prednisone. Gastroenterology 1981; 81: 944-52
  2. D’Amico G, Luca A. Natural history. Clinical-haemodynamic correlations. Prediction of the risk of bleeding. Bailliere Clin Gastroenterol 1997; 11: 243-56
  3. Merli M, Nicolini G, Angeloni S, et al. Incidence and natural history of small oesophageal varices in cirrhotic patients. J Hepatol 2003; 38: 266-72
  4. Merkel C, Marin R, Angeli P, et al. A placebo-controlled clinical trial of nadolol in the prophylaxis of growth of small oesophageal varices in cirrhosis. Gastroenterology 2004; 2: 476-84
  5. Zoli M, Merkel C, Magalotti D, et al. Natural history of cirrhotic patients with small oesophageal varices: a prospective study. Am J Gastroenterol 2000; 2: 503-8. 6. de Franchis R. Evaluation and follow-up of patients with cirrhosis and oesophageal varices. J Hepatol 2003; 38: 361- 3
  6. North-Italian Endoscopic Club for the Study and Treatment of Oesophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and oesophageal varices. N Engl J Med 1988; 319: 983-9
  7. Khaderi S, Barnes D. Preventing a first episode of esophageal variceal hemorrhage. Cleve Clin J Med 2008; 75: 235- 44
  8. Bhasin DK, Malhi NJ. Variceal bleeding and portal hypertension: much to learn, much to explore. Endoscopy 2002; 34: 119-28
  9. Merkel C, Zoli M, Siringo S, et al. Prognostic indicators of risk for first variceal bleeding in cirrhosis: a multicenter study in 711 patients to validate and improve the North Italian Endoscopic Club (NIEC) ratio. Am J Gastroenetrol 2000; 95: 2915-20
  10. D’Amico G, Pagliaro L, Bosch J. The treatment of portal hypertension. A meta-analytic review. Hepatology 1995; 22: 332-54
  11. Tripathi D, Hayes PC. Review article: a drug therapy for the prevention of variceal haemorrhage. Aliment Pharmacol Ther 2001; 15: 291-310
  12. Khuroo MS, Khuroo NS, Farahat KL, Khuroo YS, Sofi AA, Dahab ST. Meta-analysis: endoscopic variceal ligation for primary prophylaxis of oesophageal variceal bleeding. Aliment Pharmacol Ther 2005; 21: 347-61
  13. Psilopoulos D, Galanis P, Goulas S, et al. Endoscopic variceal ligation vs. propranolol for prevention of first variceal bleeding: a randomized controlled trial. Eur J Gastroenterol Hepatol 2005; 17: 1111-7
  14. Chalasani N, Imperiale TF, Ismail A, et al. Predictors of large esophageal varices in pati