PREDICTORS OF UPPER GASTROINTESTINAL-BLEEDING IN PATIENTS WITH SCHISTOSOMAL PERIPORTAL FIBROSIS

A case-control study was conducted between 1985 and 1987 in the Gezira -Managil area of central Sudan to assess the major predictors of haema temesis. Eighty-four patients who had suffered at least one attack of oesophageal bleeding and had schistosomal periportal fibrosis demonstr ated by ultrasonography were compared with 173 subjects with-out bleed ing but with ultrasonographic evidence of periportal fibrosis. A splen ic longitudinal dimension of more than 11 cm, periportal fibrosis wors e than grade I and varices more than grade I were independently associ ated with a significant risk of variceal bleeding. Age, sex, presence of a palpable liver and portal vein diameter were not associated with a significant risk of bleeding after adjustment for potential confound ing variables. Factors identified in this study could be helpful in th e prophylactic management of patients with complicated schistosomiasis .