Status of the mucosa of the upper gastrointestinal tract in patients with acute viral hepatitis B

Abstract

Introduction. Patients with acute viral hepatitis B (AVHB) during the peak may develop erosions and ulcers of the mucous membrane of the upper gastrointestinal tract, which are difficult to diagnose clinically. Aim. The differences in clinical and laboratory manifestations of acute viral hepatitis B, depending on the presence or absence of erosive and ulcerative defects of the mucous membrane of the upper gastrointestinal tract has studied. Materials and methods. The work used clinical and laboratory data and the results of endoscopic examination of 44 patients with AVHB. All patients underwent a comprehensive clinical and laboratory examination, supplemented by fibroesophagogastroduodenoscopy (FEGDS). Results. Among 44 patients with AVHB, complaints of a dyspeptic character occurred in 79.6% (35 patients) and did not depend on the severity of the course of AVHВ. FEGDS of patients with AVHB revealed various pathological changes in the mucous membrane from superficial gastritis and gastroduodenitis (61.4%) to erosive gastroduodenitis and acute ulcers of the mucous membrane of the duodenal bulb (38.6%). Erosive and ulcerative defects of the mucous membrane of the upper gastrointestinal tract (ММUGIT) were more often diagnosed in the first 9 days from the onset of AVHB and was acute. Еrosions and ulcers of the GIТ tract with AVHB were less often than non-erosive gastritis/gastroduodenitis accompanied by such dyspeptic complaints as epigastric pain, nausea, and vomiting, which excludes dyspeptic syndrome as an evidence-based clinical landmark in diagnosing the degree of damage to the mucous membrane of the upper gastrointestinal tract. However, patients with AVHB with erosive and ulcerative defects of the ММUGIT had a significantly higher level of ALT at admission than patients with EVHV with gastritis/gastroduodenitis (1860 U/l (1030.2889) vs. 910 U/l (325.1749), p< 0 .05). Conclusion: In order to identify erosive-ulcerative defects of the mucous membrane of the upper gastrointestinal tract in patients with AVHB the FEGDS should be performed in the first 9 days of the disease in the presence of high ALT activity, which will allow to correct the tactics of managing patients with AVHВ earlier.