Reda Elwakil¹*, Sara M Abdelhakam¹, Mohammad A Sakr¹, Waleed A Hamed¹, Waleed S Abdelmoaty¹, Zakaria H Ibrahim¹, Mohamed El-Gharib², Omar Elwakil¹ and Dalia Ghoraba¹

¹Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
²Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt

*Corresponding Author: Reda Elwakil, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Received: December 13, 2024; Published: December 24, 2024

Abstract

Non-cirrhotic portal hypertension (NCPH) represents infrequent conditions that cause portal hypertension in the absence of cir rhosis. This study evaluated predictors of upper gastrointestinal bleeding in Egyptian patients with NCPH.

One hundred Egyptian patients suffering from NCPH without a previous history of upper GIT bleeding were included and followed up for two years. All underwent laboratory investigations, Colour Doppler ultrasonography, and upper gastrointestinal tract (GIT) endoscopy. They were classified into two groups: Group I, which included 34 patients with bleeding during the follow-up period, and Group II, which included 66 patients without bleeding.

Budd Chiari syndrome was the commonest aetiology (73%), followed by extrahepatic portal vein thrombosis (13%), schistoso miasis (3%), venocclusive disease (1%), arterio-venous fistula (1%), congenital hepatic fibrosis (1%) and idiopathic NCPH (8%).

The mean splenic size (cm), portal vein (mm), and splenic vein (mm) diameters were higher in bleeders than in non-bleeders (P < 0.01). The mean portal vein flow velocity (cm/sec) and platelet count/spleen diameter ratio were lower in bleeders than in non bleeders (P = 0.003 and 0.001, respectively). The presence of three or more variceal columns, larger grades of esophageal varices, and risk signs were significantly detected in the bleeders group. Stepwise logistic regression analysis showed that splenic vein diameter (> 10 mm) (OR = 2.64, P = 0.008), platelet count/spleen diameter (mm) ratio (< 1000) (OR = 0.999, P = 0.009) and number of columns of oesophageal varices (≥ 3) (OR = 27.2, P = 0.001) were independent risk factors for upper GIT bleeding.

In conclusion, splenic vein diameter, platelet count/spleen diameter ratio, and the number of columns of oesophageal varices were independent predictors of upper GIT bleeding in NCPH.

Keywords: Budd Chiari Syndrome; Portal Vein Thrombosis; Upper Git Bleeding; Splenic Vein Diameter; Platelet Count/Spleen Di ameter Ratio

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Citation

Citation: Reda Elwakil., et al. “Predictors of Upper Gastrointestinal Bleeding in Egyptian Patients with Non-Cirrhotic Portal Hypertension".Acta Scientific Gastrointestinal Disorders 8.1 (2025): 27-35.

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Copyright: © 2025 Reda Elwakil., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.