| Abstract | Ezofagogastrosduodenoskopija predstavlja zlatni standard u dijagnostici sluzničkih promjena gornjeg gastrointestinalnog sustava te je kod bolesnika s terminalnom bolesti jetre ključna u evaluaciji promjena povezanih s portalnom hipertenzijom. Cilj ovog istraživanja bio je utvrditi prevalenciju endoskopskih promjena, povezanih i nepovezanih s portalnom hipertenzijom, kod kandidata za transplantaciju jetre te utvrditi postojanje eventualnih razlika pojavnosti promjena između različitih etioloških skupina bolesnika s obzirom na primarnu bolest jetre. Analizirana su 144 nalaza ezofagogastroduodenoskopije bolesnika koji su podvrgnuti transplantaciji jetre u KB Merkur. Kohorta je uključivala 75,0% muškaraca i 25,0% žena, prosječne starosti 54,8±10,5 godina. Analizirani patološki entiteti podijeljeni su u dvije skupine: promjene povezane s portalnom hipertenzijom (varikoziteti jednjaka, varikoziteti fundusa, portalna hipertenzivna gastropatija) i promjene nepovezane s portalnom hipertenzijom (ezofagitis, gastritis, erozije, ulkus želuca, polipi želuca, duodenitis i ulkus duodenuma); dok su bolesnici podijeljeni u 4 skupine prema etiologiji na one s: alkoholnom, virusnom, autoimunom i ostalim etiologijama. Ukupna prevalencija promjena povezanih s portalnom hipertenzijom iznosila je 75,7%, a nepovezanih 63.19%. Varikoziteti jednjaka nađeni su kod 70,1% bolesnika, varikoziteti fundusa kod 9,0%, a PHG kod 28,5%. Od ostalih promjena, najčešći je bio nalaz gastritisa (35,8%) i erozija želuca (23,0%). Između pojedinih etioloških skupina nije bilo statistički značajne razlike s obzirom na prevalenciju promjena nepovezanih s portalnom hipertenzijom, dok su značajno nižu prevalenciju (p=0,002) varikoziteta jednjaka imali bolesnici heterogene, tzv. ostale skupine bolesnika. Osim očekivane visoke prevalencije promjena povezanih s portalnom hipertenzijom, ova analiza ukazuje na iznimno visoku prevalenciju peptičkih promjena bolesnika s terminalnom bolesti jetre te upućuje na dodatnu patologiju ove iznimno vulnerabilne skupine bolesnika. |
| Abstract (english) | Esophagogastroduodenoscopy is the golden standard for diagnostics of mucosal changes in the upper gastrointestinal system, and it is essential in evaluation of changes related to portal hypertension in patients with end-stage liver disease.
The aim of this study was to determine the prevalence of endoscopic findings, related and unrelated to portal hypertension, in liver transplantation candidates and to find out if there are any differences in prevalence of endoscopic findings between the groups of patients with different etiology of their primary liver disease. Esophagogastroduodenoscopy records of 144 patients who underwent liver transplantation in Clinical hospital „Merkur” were analyzed. The cohort included 75,0% males and 25,0% females, aging 54,8±10,5 years. The analyzed pathologic entities were divided in two groups: findings related to portal hypertension (esophageal varices, gastric varices, PHG) and findings unrelated to portal hypertension (esophagitis, gastritis, gastric erosions, polyps, gastric ulcer, duodenitis, duodenal ulcer); while the patients were divided in four groups according to the disease etiology (alcoholic, viral, autoimmune and other etiologies). Prevalence of changes related to portal hypertension in all patients was 70,1%, and 63.19% had changes unrelated to portal hypertension. Esophageal varices were found in 70,1% of patients, gastric varices in 9,0%, and PHG in 28,5% of all patients. The most frequent of all the other findings were gastritis (35,8%) and gastric erosions (23,0%). There were no statistically significant differences in prevalence of findings unrelated to portal hypertension between groups with different disease etiologies. Howewer, the prevalence of esophageal varices was significantly (p=0,002) lower in the heterogeneous group of patients with other etiologies. Besides the expected high prevalence of findings related to portal hypertension, this analysis suggests an extremely high prevalence of peptic lesions in patients with end-stage liver disease and indicates the importance of this additional pathology in very vulnerable group of patients. |
