Upper Digestive Lesions Not Linked to Portal Hypertension during Cirrhosis: About 82 Cases in the Hepato-Gastroenterology Department of Aristide Le Dantec Hospital

摘要

Introduction: The aim of this study was to determine the frequency of digestive lesions unrelated to portal hypertension during cirrhosis and to look for a possible correlation between these lesions and the severity of chronic liver disease. Material and method: Over a period of 15 months (April 1, 2014 to June 30, 2015), all the records of cirrhotic patients who followed up on an outpatient or inpatient basis in the hepato-gastroenterology department of the Aristide Le Dantec Hospital were collected. The data collected were as follows: age, sex, Child-Pugh severity score, etiology of cirrhosis, indication for endoscopy and endoscopic lesions observed. Results: Data were analyzed from 82 patient records with a mean age of 43 years (range 16 and 79 years) and a sex ratio of 1.4 (54 males). Cirrhosis was classified as Child-Pugh B in 47% of cases and Child-Pugh C in 35% of cases. The etiology was viral B in 75 patients (91.5%), B-D co-infection in 2 cases, and alcoholic in 1 case. The indication for oeso-gastroduodenal endoscopy was a systematic search for signs of portal hypertension in 66 cases (80.4%), upper gastrointestinal haemorrhage in 11 cases (13.4%) and epigastralgia in 6.2% of cases. Endoscopic lesions unrelated to portal hypertension were observed in 61 patients (74.4%). Peptic ulcer was present in 26 patients (31.7%), and congestive gastrobulbitis was observed in 38 patients (46.3%) and erosive gastrobulbitis in 32 patients (39%). Of the 43 upper GI endoscopies with biopsies, Helicobacter pylori was found at histology in 17 cases (39.5%). Eighteen patients (21.9%) had esophageal candidiasis. In multivariate analysis, there was no association between no portal hypertension lesions and the severity of cirrhosis. Conclusion:Upper gastro intestinal lesions unrelated to hypertension were present in 3/4 of cirrhotic patients. Peptic ulcer disease and congestive and erosive gastrobulbitis were the most frequently observed lesions. There was no significant association between non-PTH-related lesions and the severity of cirrhosis.