الفهرس 
Portal hypertensionOnly 14 pages are availabe for public view
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Abstract
P
ortal hypertensive gastropathy (PHG) is one of the clinical conditions that can cause chronic gastro-intestinal hemorrhage in patients with cirrhosis, manifested by chronic anemia. It is generally diagnosed on the basis of endoscopic features.
A new thermal modality has recently been introduced to endoscopy: the argon plasma coagulator (APC). APC is a novel non-contact diathermal technique in which high-frequency alternating current is applied to the tissue through a stream of ionized argon gas resulting in thermal coagulation of tissue. Thermal effects of APC such as devitalization, coagulation, desiccation and tissue shrinking can be used for hemostasis. It has the major advantage that the depth of coagulation is automatically limited by a thin, electrically insulating layer which develops due to desiccation of the superficial tissue layer. Hemostasis is a main target for the use of APC and its role in ceasing PHG related acute and chronic bleeding is being efficient and safe when studied in the past few years.
This study was performed to evaluate the role of argon plasma coagulation in comparison with non selective beta blockers for the treatment of chronic blood loss and iron deficiency anemia in cirrhotic patients with severe portal hypertensive gastropathy.
This study included 30 cirrhotic anemic patients who had severe PHG. The patients were divided into two groups, group (A) included 20 patients who had argon plasma coagulation (APC) sessions and group (B) included 10 patients who received propranolol as oral therapy. Response to the treatment was assessed by the change in hemoglobin and iron parameters over the following 2 months after the start of therapy.
On comparing laboratory investigations between 1st visit and 2, 4, 6 and 8 weeks after the 1st visit in group (A) patients, there was a highly significant increase in hemoglobin level, serum iron, serum ferritin and transferrin saturation with a significant decrease in TIBC. This means that there was an overall improvement of anemia and iron deficiency.
Specific treatment of PHG is mainly based on portal pressure reducing approaches. The use of non-selective beta blockers (Propranolol) which has been shown to reduce bleeding from both acute and chronic forms of GIT bleeding secondary to PHG.
On comparing laboratory investigations between 1st visit and 2, 4, 6 and 8 weeks after the 1st visit in the use of beta-blockers (group B) is associated with the gradual increase in the mean of hemoglobin, serum iron, transferrine saturation and serum ferritin and gradual decrease of TIBC.
There was statistically significant difference between the two groups as regards the changes in hemoglobin and iron study in the second, third, fourth and fifth visits respectively when compared with the first visit that means that the increase in hemoglobin, serum ferritin, serum iron is more in APC group patients than beta-blockers group patients and the decrease in TIBC is more in APC group patients than beta-blockers group patients, so the improvement in hemoglobin and iron study variables is better in APC group patients than detected in beta-blockers group patients.