Premium
Risk factors for sinistral portal hypertension and related variceal bleeding in patients with chronic pancreatitis
Author(s) -
Ru Nan,
He Chao Hui,
Ren Xin Lu,
Chen Jia Yun,
Yu Fei Fei,
Yan Zi Jun,
Guo Ji Yao,
Zhu Jia Hui,
Wang Yuan Chen,
Qian Yang Yang,
Pan Jun,
Hu Liang Hao,
Li Zhao Shen,
Zou Wen Bin,
Liao Zhuan
Publication year - 2020
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12916
Subject(s) - medicine , pancreatitis , complication , gastrointestinal bleeding , univariate analysis , portal hypertension , varices , gastroenterology , gastric varices , surgery , risk factor , diabetes mellitus , multivariate analysis , cirrhosis , endocrinology
Objectives Sinistral portal hypertension (SPH) is an uncommon complication of chronic pancreatitis (CP) and can result in severe gastrointestinal bleeding. The aim of this study was to determine the prevalence and the potential risk factors for SPH and related gastrointestinal variceal bleeding in patients with CP. Methods We retrospectively reviewed all patients with SPH due to CP admitted to our hospital from July 2014 to June 2019 in this case‐control study. Patients with CP without SPH were randomly selected as controls during the study period (case: control = 1:2). The characteristics, medical history, course of CP, characteristics associated with SPH, and follow‐up evaluations of the patients were documented in detail. The prevalence rate of SPH in patients with CP and related gastrointestinal bleeding was calculated. Risk factors for SPH and related variceal bleeding were analyzed using univariate or multivariate logistic regression analysis. Results The prevalence of SPH was 2.7% (89/3358) in patients with CP. Independent risk factors for SPH included alcohol consumption ( P = 0.030), history of acute pancreatitis ( P = 0.010), diabetes mellitus ( P < 0.001), and pseudocysts ( P < 0.001). Overall 17 (19.1%) patients suffered from related gastrointestinal bleeding. Between the bleeding and non‐bleeding groups, there were significant differences in the types of CP, existence of stones, gastric varices diagnosed before bleeding, splenomegaly and hypersplenism by univariate analysis. Conclusion SPH is a rare complication of CP that is associated with a relatively low risk of variceal bleeding.