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KARACİĞER SİROZU VE ÖZOFAGOGASTRİK VARİSLER

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2002

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Abstract (2. Language): 
Liver cirrhosis and esophagogastric varices. This study was undertaken to evaluate the frequ-ency of esophagogastric varices in cirrhosis and to determine the relationship betvveen these varices and liver functions. Total 536 ciırhotic patients that diagnosed by laparoscopy and/or percutaneous liver biopsy were included. Of 536 patients, 335 were decompansated and 201 were compansated cirrhosis. Frequency of esophago-gastric varices; relationship betvveen varices and age, gender, etiology of cirrhosis, liver functions were evaluated retrospectively. Eosophagial varices vvere observed in 490 patients (%91.4). Despite there vvas no difference betvveen patients vvith and vvithout varices as age and etiology, Child-Pugh score vvas higlıer in patients vvith varices (8.6+2.9-6.7+1.1, p<0.01). As varice frequency, no statistical difference vvas determined betvveen compansated and decompansated patients (p>0.05). Grade III varices vvere more common in decompansated patients than compansated ones (p=0.005). Frequency of grade III varices in Child-Pugh B and C group vvas more than Child-Pugh A patients (Child A-B, p<0.035, Child A-C, p=0.007). In 180 patients (33.5%), esophagial varices; in 106 (19.7%), fundic varices and in 226 (42%), portal hypertensive gastropathy vvere observed. In addition to esophageal varices, 3 patients had antral varices and 2 had duodenal varices. Of patients vvith grade III varices, 86 (47.7%) had previously experienced variceal bleeding. Frequency of esophago-gastric varice is high in cirrhotic patients. The increase in Child-Pugh score causes the increase in frequency of grade II-III esophagel varices and in risk of bleeding.
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Abstract (Original Language): 
Karaciğer sirozunda özofagogastrik varis sıklığının araştırılması ve özofagogastrik varislerle karaciğer fonksiyonları arasındaki ilişkilerin belirlenmesidir. Laparoskopi ve/veya karaciğer biyopsisi ile teşhis edilmiş olan, 335 dekompanse (DKS) ve 201 kompanse karaciğer sirozu (KKS), toplam 536 vakada retrospektif olarak özofagogastrik varis sıklığı araştırılmış, varislerin yaş, cinsiyet, siroz etiyolojisi ve karaciğer fonksiyonları ile ilişkileri incelenmiştir. Özofagus varisleri 536 vakanın 490 tanesinde (%91.4) mevcuttu. Yaş ve etiyolojik dağılım açısından varisi olan ve olmayan gruplar arasında fark saptanmazken, varisi olan grupda Child Pugh skoru daha yüksek idi (8.6±2.9-6.7±l.l, p<0.01). Kompanse ve dekompanse karaciğer sirozu vakalarında, varis sıklığı açısından fark yoktu (p>0.05). DKS vakalarında (%36), KKS vakalarına (%23) göre daha yüksek oranda grade III varisler mevcuttu (p=0.005). Child B ve C'de Child A'ya göre daha yüksek oranda grade III özofagus varisleri saptandı (Child A-B, p=0.035, Child A-C, p=0.007). Grade III özofagus varisleri 180 (%33.5), fundus varisleri 106 (%19.7) ve portal hipertansif gastropati ise 226 (%42.1) vakada saptandı. Özofagus varisleri ile birlikte, 3 vakada antrum varisi, 2 vakada ise duodenal varis mevcuttu. Grade III özofagus varisleri olan vakaların 86'sı (%47.7) varise bağlı kanama geçirmişti. Karaciğer sirozunda yüksek oranda özofagogastrik varis sıklığı saptanmaktadır. Child-Pugh evresinde artışla birlikte daha yüksek oranlarda grade II-III özofagus varisleri saptanmakta ve bu durum artmış özofagus varislerine bağlı kanama riski ile birlikte seyretmektedir.
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  • 2
120-124
  • Turkish

REFERENCES

References: 

Battista S, Bar F, Mengozzi G, Zanon E, Grosso M, Mo-lino G: Hyperdynamic circulation in patients with cirrhosis: Direct measurement of nitric oxide levels in hepatic and portal veins. J Hepatol 26:75, (1997)
2. Bomzon A, Blendis L: The nitric oxide lıypothesis and the hyperdynamic circulation in cirrhosis. Hepatology 20:1343,(1994)
3. Cales P, Desmorat H, Vinel JP, Caucanas JP, Ravaud A, Gerin P, Brouet P, Pascal JP: Incidence of large oesopha-geal varices in patients with cirrhosis: Application to prophylaxis of first variceal bleeding. Gut 31:1298, (1990)
4. Cales P, Desmorat H, Ravaud A et al: Incidence and rate of occurrence of large oesophageal varices in cirrhotic patients: Application to screening for prophylaxis of first haemorrhage. J Hepatol 7:S 15,(1988)
5. Canıpillo B, Bories PN, Benvenuti C, et al: Serum and urinary nitrate levels in liver cirrhosis: Endotoxemia, renal function and hyperdynamic circulation. J Hepatol 25:707,(1996)
6. Colombato LA, Albillos A, Groszmann RJ: Temporal relationship of peripheral vasodilation, plasma volume ex-pansion and the hyperdynamic circulatory state in portal hypertensive rats. Hepatology 15:323, (1991)
7. Cooper RA: Hemolytic syndromes and red celi membra-ne abnormalities in liver disease. Semin Hematol 17: 103-12(1980).
8. DeDombal FT, Claıke JR, Clamp SE: Prognostic factoıs in upperG.I. bleeding. Endoscopy 18:6, (1986)
9. DeFranchis R: Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. N Engl J Med 319:983, (1988)
10. DeFranchis R, Primignani M: Why do varices bleed? Gastroenterol Clin North Am 21:85, (1992)
11. Gaiani S, Bolondi L, Fenyves D, Zironi G, Rigamonti A, Barbara L: Effect of propranolol on portosystemic colla-teral circulation in patients with cirrhosis. Hepatology 14:824, (1991)
12. Garceau AJ, Chalmers TC, The Boston Inter-Hospital Liver Group. The natural history of cirrhosis:I.Survival with esophageal varices. N Engl J Med 268:469-73, (1963)
13. Gores GJ, Wilsner RW, Dickson ER, et al: Prospective
evaluation of esophageal varices in prinıary biliary cirrhosis: Development, natural history and influence on sur-vival. Gastroenterology 96:1552, (1989)
14. Grace ND, Conn HO, Resnick RH, Groszmann RJ, At-terbury CE, Wright SC, Gusberg RJ, Vollman R, Garcia-Tsao G, Fisher RL: Distal splenorenal vs portal-systemic shunts after hemorrhage from varices: A randomized controlled trial. Hepatology 8:1475, (1988)
15. Hartleb M, Michielsen PP, Dziıırkowska Marek A: The role of nitric oxide in portal hypertensive systemic and portal vascular pathology. Açta Gastroenterol Belg 60:222,(1997)
16. Michielsen PP, Pelckmans PA: Haemodynamic changes in portal hypertension: New insights in the pathogenesis and clinical implications. Açta Gastroenterol Belg 57:194,(1994)
17. Nevens F, Bustami R, Scheys I, Lesaffre E, Fevery J: Variceal pressure is a factor predicting the risk of a first variceal bleeding: A prospective cohort study in cirrhotic subjects. Hepatology 27:5, (1998)
18. Ökten A: Türkiye'de karaciğer sirozunun etiyolojisi. He-patolojide Güncel Gelişmeler sempozyumu, sf 67-69 (1998)
19. Pagliaro L, D'Amico G, Pasta L: Portal hypertension in cirrhosis: Natural history. In Bosch J, Groszmann RJ (eds): Portal hypertension: Patophysiology and Treat-ment. Oxford, Blackvvell Scientific Publications, pp 72-92,(1994)
20. Rigo GP, Merighi A, Chahin NJ, Mastronardi M, Code-luppi PL, Ferrari A, Armocida C, Zanasi G, Cristani A, Cioni G: A prospective study of the ability of three en-doscopic classification to predict hemorrhage from esophageal varices. Gastrointest Endosc 38:425-9 (1992)
21. Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makvvana UK: Prevalance, classification and natural history of gastric varices'.Long-tenn follovv up study in 568 patients vvith portal hypertension. Hepatology 95:434, (1992)
22. Seiber CC, Groszmann RJ: Nitric oxide mediates hypo-reactivity to vasopressors in mesenteric vessels of portal hypertensive rats. Gastroenterology 103:1043, (1992)
23. Shah VH, Kamath PS: New developments in portal hypertensive bleeding. Clin Perspective in Gastroenterol 5:17-22(2002)
24. Velimir AL, Arun JS: Esophageal varices. Gastroenterology Clinics of North America. 29: 337-385,(2000)

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