الفهرس | Only 14 pages are availabe for public view |
Abstract This study was carried out on 20 patients with liver cirrhosis and active esophageal variceal haemorrhage, admited at El-Menoufiya University Hospitals. They were randomly assign to receive endoscopic injection sclerotherapy. The consent was taken from the patients or their relatives before starting the study and they had the right to refuse at any time. Diagnosis of cirrhosis was based on clinical data, biochemical studies and sonographic imaging. The severity of cirrhosis was estimated by Pugh’s modification of Child’s classification. All patients in this study were subjected to the following: A- Detailed history: including history of present illness, amount of blood transfusion. Past history of simmilar attack and intake of diuretics or vasoactive drugs. B- Clinical examination: 1. General examination. 2. Full clinical abdominal and pelvic examination. C- Laboratory investigations: including total serum bilirubin , AST, ALT, serum albumin , prothrombin time , complete blood picture , serum creatinine . D- Radiological investigations: The study was performed in all cases before and after endoscopic injection sclerotherapy. This included : 1- Abdominal Sonography . 2- Duplex Doppler Ultrasonographic haemodynamic Study including : ·Mean blood flow velocity of portal and splenic viens (cm / sec)= CSVmax x 0.57. CAVmax = maximum cross sectional velocity (Moriyasu et al., 1986 ). ·Portal and splenic blood flow volume (cm3 / sec ) = mean blood flow velocity ( cm / sec ) x cross sectional area (ð r² in cm² ). r² = ( half the diameter of the vessel cross sectional area ) ² and ð is constant equal 22 / 7( Nelson et al., 1987; Patriquin et al ., 1987 ). ·The congestion index of portal and splenic veins ( CI ) = cross sectional area (ð r² ) / mean blood flow velocity (cm / sec)(Moriyasu et al., 1986 ). ·The ratio of flow volume in splenic vein to flow volume in the potal trunk (SV/PT ) was also calculated. E- Endoscopic injection sclerotherapy: Ethanolamine oleate was injected via 22 gauge sclerotherapy disposable needle. The sclerosant was carefully injected intravariceal. No more than 20 ml of sclerosant was injected in each session. |