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. Study Design: Cross sectional study.
Setting: Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad.
Period: 1st August 2007 to 31st July 2008. Materials and Methods: 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.