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Natural history of patients with non cirrhotic portal hypertension: Comparison with patients with compensated cirrhosis.
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2018 Aug; Vol. 50 (8), pp. 839-844. Date of Electronic Publication: 2018 Jan 31. - Publication Year :
- 2018
-
Abstract
- Background: The knowledge of natural history of patients with portal hypertension (PH) not due to cirrhosis is less well known than that of cirrhotic patients.<br />Aim: To describe the clinical presentation and the outcomes of 89 patients with non-cirrhotic PH (25 with non-cirrhotic portal hypertension, INCPH, and 64 with chronic portal vein thrombosis, PVT) in comparison with 77 patients with Child A cirrhosis.<br />Methods: The patients were submitted to a standardized clinical, laboratory, ultrasonographic and endoscopic follow-up. Variceal progression, incidence of variceal bleeding, portal vein thrombosis, ascites and survival were recorded.<br />Results: At presentation, the prevalence of varices, variceal bleeding and ascites was similar in the 3 groups. During follow-up, the rate of progression to varices at risk of bleeding (p < 0.0001) and the incidence of first variceal bleeding (p = 0.02) were significantly higher in non-cirrhotic then in cirrhotic patients. A PVT developed in 32% of INCPH patients and in 18% of cirrhotics (p = 0.02).<br />Conclusions: In the patients with non-cirrhotic PH variceal progression is more rapid and bleeding more frequent than in cirrhotics. Patients with INCPH are particularly prompt to develop PVT. This observational study suggests that the management of patients with non-cirrhotic PH should take into consideration the natural history of portal hypertension in these patients and cannot be simply derived by the observation of cirrhotic patients.<br /> (Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Ascites etiology
Disease Progression
Female
Gastrointestinal Hemorrhage etiology
Humans
Hypertension, Portal complications
Liver Cirrhosis complications
Male
Middle Aged
Multivariate Analysis
Portal Vein physiopathology
Proportional Hazards Models
Esophageal and Gastric Varices complications
Hypertension, Portal etiology
Hypertension, Portal physiopathology
Liver Cirrhosis physiopathology
Venous Thrombosis physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 50
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 29429910
- Full Text :
- https://doi.org/10.1016/j.dld.2018.01.132