Abstract
Introduction: Esophageal varices bleeding (EVB) in liver cirrhosis is an important cause of mortality and morbidity. We aimed to study the relationship between systolic pulmonary artery pressure (sPAP) and EV grade and EVB.Methods: A total of 229 patients, 183 male and 46 female, who were determined to have EV in the upper gastrointestinal tract endoscopy and who had a transthoracic echocardiogram (TTE) were included in this study.Results: The frequency of pulmonary hypertension (PHT) and EVB was determined to be 16% and 45%, respectively, in our study, and 20% of those who had bleeding had PHT; 70.3% of the cases with PHT were determined to have grade III varices while this rate was lower at 52.9% in cirrhosis without PHT. A significant correlation was determined between Model for End-Stage Liver Disease (MELD) score, Child-Turcotte-Pugh score, platelet, albumin, and sPAP in those without a history of bleeding (p<0.05).Conclusion: An increase in the rate of grade III varices has been noted along with the prevalence of PHT in patients with portal hypertension. It has been determined that the increase in PAP is associated with an increase in the MELD score, which is closely associated with mortality and morbidity. Therefore, this positive relationship between the MELD score and PHT may lead to an increase in the frequency of advanced-stage EV.
Highlights
Esophageal varices bleeding (EVB) in liver cirrhosis is an important cause of mortality and morbidity
EVB was observed in 20% of cases with pulmonary hypertension (PHT)
No statistically significant difference was determined between the groups in terms of esophageal varices (EV) grade (p=0.343)
Summary
Esophageal varices bleeding (EVB) in liver cirrhosis is an important cause of mortality and morbidity. Liver cirrhosis (LC) is caused by long-term or repeated damages to liver tissues due to one or more reasons. These repeated damages cause an increase in intrahepatic vascular pressure along with the formation of generalized hepatocyte necrosis, fibrous tissue hyperplasia, and regenerative nodules. Numerous spontaneous portosystemic shunts and esophageal varices (EV) may occur as a complication of long-term PH in patients with LC [2]. Varices bleeding occurs at a rate of 5% annually and it is associated with a high mortality rate (15%-25% in six weeks) [3]
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