SRINAGAR: Department of surgical gastroenterology conducted a day long awareness program on Portal Hypertension at Sheri Kashmir Institute of Medical Science (SKIMS) on Doctors day.
Portal hypertension is above normal pressures in PVS due to Pre-sinusoidal (EHPVO), Sinusoidal (Cirrhosis) or Post-sinusoidal (BCS) Obstruction.
“In Portal Hypertension, blood that normally flows through the liver is diverted into systemic veins because of increased resistance to portal venous flow. The most common portosystemic anastomosis is via the left gastric –gastro-esophageal route, it occurs in 80-90 % of patients and gives rise to lower esophageal and gastric varices,” said Prof, S Nundy, pioneer of Surgical Gastroenterology in India.
Minister for Health & Medical Education, Bali Bhagat was chief guest on the occasion, while as the internationally recognized faculty in the field besides the faculty from SKIMS Medical College, Government Medical College Srinagar and its associated hospitals participated.
Bali maintained that SKIMS, being a premier institution of state not only caters the patients’ rush from valley but from all other parts of the state and extends specialized treatment to hundreds of patients. He also acknowledged the excellent work done by the Institute during the last year uprising wherein several people from different parts of Valley were provided specialized treat-ment round the clock.
Most patients with portal hypertension have intrinsic liver disease
“20 percent of patients with Portal Hypertension have gastric varices (GV’S) and are source of bleeding in 10-30% of variceal hemorrhage. Gastric Varices are dilated submucosal vein in the stomach, which can be a life- threatening cause of bleeding in the upper gastrointestinal tract ,” said Prof. Ajay Kumar, chairman Fortis Escorts liver and digestive disease New Delhi who speaks about the topic Gastric Varices .
The data of 508 patients with portable Hypertension treated surgically in 1995- 2001
“256 were treated with portaazygous devascularization (PAD) , 167 with portasystemic shunts (PSS) , 62 with selective shunts (SS) ,11 with combined portasystemic shunt and portaazygous devascularization (PSS-PAD),” said organizer sectary of Surgical Gastroenterology Dr. Sadaf Ali .
Devascularization is a viable option for management portal Hypertension bleed of various etiology.
“It carries slightly higher incident of re-bleeding and Endotherapy is first line treatment in symptomatic biliopathy shunt surgery may be needed if Endotherapy fails,” she further added.
Director SKIMS Prof. A.G Ahangar spoke highly of the quality of work and volume of patients addressed in the department of Surgical GE with the contribution well taken over all around the globe. He welcomed the Minister and other dignitaries for gracing the occasion.