Çocukluk çağında portal hipertansiyon: İki merkez deneyimi ve literatür incelemesi
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Date
2015-08-19
Authors
Appak, Yeliz Çağan
Ünal, Fatih
Kasırga, Erhun
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Giriş: Bu çalışmada portal hipertansiyon (PHT) nedeni ile izlediğimiz hastalarımızın değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 2005-2013 yılları arasında izlenen toplam 21 PHT’li hasta retrospektif olarak demografik verileri, başvuru nedenleri ve uygulanan tedaviler açısından değerlendirilmiştir. Bulgular: Çalışmaya alınan hastaların ortalama yaşı 9,3±5,3 yıl olup, %38,1’i kız, %61,9’u erkek idi. Hastaların %28,6’sının gastrointestinal sistem (GİS) kanaması, %14,3’ünün karında şişlik, %28,6’sının splenomegali, %9,5’inin hepatosplenomegali ve %19’unun karaciğer fonksiyon testlerinde yükseklik nedeni ile başvuru sonrası PHT tanısı aldığı görüldü. Ortalama tanı yaşı 6,8±4,7 yıl, ortalama izlem süresi 3,4±1,7 yıl idi. Üst GİS endoskopisinde hastaların %85,7’sinde özofagus varisleri saptanmış, bir hasta dışında tüm hastalara beta bloker tedavi başlanmıştır. Hastaların izlemleri süresince %52,4’ünde PHT sekonder GİS kanaması görülmüştür. Hastaların %4,8’ine skleroterapi, %19’una bant ligasyonu, %23,8’ine bant ligasyonu ve skleroterapi beraber uygulanmıştır. Bir hastaya rex şantı ve iki hastaya distal splenorenal şant yapılmıştır. Sonuç: PHT takibinde varis kanaması en önemli komplikasyondur. Hastalarda erken tanı ile medikal, endoskopik ve cerrahi önlemlerin alınması sonucu portal hipertansiyon komplikasyonları engellenebilir.
Introduction: In this study, our objective is to make an assessment of the patients whom we have followed with portal hypertension. Materials and Methods: A total of 21 portal hypertension patients, followed between 2005 and 2013, were evaluated retrospectively with regards to demographic data, complaints leading to their application and treatments they received. Results: The average age of the patients was 9.3±5.3, 38.1% of the patients were female and 61.9% were male. Of the patients, 28.6% received portal hypertension diagnosis due to gastrointestinal system bleeding, 14.3% due to abdominal distention, 28.6% due to splenomegaly, 9.5% due to hepatosplenomegaly and 19% due to elevated liver function tests. The average age of receiving the diagnosis was 6.8±4.7 and duration of the follow-up was 3.4±1.7 years. Of the patients, 85.7% had esophageal varices according to the upper gastrointestinal system endoscopy and beta-blocker therapy was applied to all patients except for one. The follow-up of the patients revealed that 52.4% of them had gastrointestinal bleeding secondary to portal hypertension. The patients received sclerotherapy (4.8%), band ligation (19%), band ligation and sclerotherapy together (23.8%). One patient received Rex Shunt and two patients had distal splenorenal shunt. Conclusions: Variceal hemorrhage is the most important complication observed in the follow-up of the portal hypertension. Portal hypertension complications can be prevented with early diagnosis as a result of taking medical, endoscopic and surgical measures.
Introduction: In this study, our objective is to make an assessment of the patients whom we have followed with portal hypertension. Materials and Methods: A total of 21 portal hypertension patients, followed between 2005 and 2013, were evaluated retrospectively with regards to demographic data, complaints leading to their application and treatments they received. Results: The average age of the patients was 9.3±5.3, 38.1% of the patients were female and 61.9% were male. Of the patients, 28.6% received portal hypertension diagnosis due to gastrointestinal system bleeding, 14.3% due to abdominal distention, 28.6% due to splenomegaly, 9.5% due to hepatosplenomegaly and 19% due to elevated liver function tests. The average age of receiving the diagnosis was 6.8±4.7 and duration of the follow-up was 3.4±1.7 years. Of the patients, 85.7% had esophageal varices according to the upper gastrointestinal system endoscopy and beta-blocker therapy was applied to all patients except for one. The follow-up of the patients revealed that 52.4% of them had gastrointestinal bleeding secondary to portal hypertension. The patients received sclerotherapy (4.8%), band ligation (19%), band ligation and sclerotherapy together (23.8%). One patient received Rex Shunt and two patients had distal splenorenal shunt. Conclusions: Variceal hemorrhage is the most important complication observed in the follow-up of the portal hypertension. Portal hypertension complications can be prevented with early diagnosis as a result of taking medical, endoscopic and surgical measures.
Description
Keywords
Portal hipertansiyon, Özofagus varisi, Skleroterapi, Bant ligasyonu, Portal hypertension, Esophageal varices, Sclerotherapy, Band ligation
Citation
Appak, Y. Ç. vd. (2015). "Çölyak hastası çocuklarda duodenal histopatoloji ve güçlü pozitif doku transglutaminaz antikorları arasındaki ilişki". Güncel Pediatri, 13(3), 177-182.