[Factors influencing the development of portal hypertensive gastropathy with liver fibrosis in schistosomiasis].

ABSTRACT

OBJECTIVE: To evaluate the factors influencing the development of portal hypertensive gastropathy (PHG) with liver fibrosis in schistosomiasis japonica. METHODS: A retrospective study was executed on 196 hospitalized patients with schistosomiasis liver fibrosis (109 of them complicated with PHG) from 1998 to 2002. Endoscopic examinations were carried out for all the cases. The analysis was made with a comparison of the PHG incidence to the degree of esophageal varices and the degree of liver function according to Child Pugh's scores. RESULTS: With slight, moderate and severe degree of esophageal varices, the PHG incidence was 47.7%, 54.8%, and 59.1% respectively (P > 0.05). With the Child pugh's classes of A, B and C, the PHG incidence was 56.0%, 53.3%, and 63.6% respectively (P > 0.05). With no surgical intervention, it was 51.3%, and with splenectomy, only 50.0%. With splenectomy plus an operation of transection and an endoscopic sclerotherapy, it was 70.6% and 85.0%. The PHG incidence was significantly higher in the group of splenectomy plus operation of transection and the group with endoscopic sclerotherapy than the group with no surgical intervention (P < 0.05). CONCLUSION: The PHG incidence in schistosomiasis liver fibrosis has no relationship with the degree of esophageal varices and Child Pugh classes of liver function. However, splenectomy plus transection and endoscopic sclerotherapy may accelerate the PHG development.