Serum-Ascites Albumin Concentration Gradient And Portal Hypertension An Endoscopic And Sonographic Study

This study included 60 patients with liver cirrhosis and portal hypertension, selected from chronic liver disease -patients admitted to Zagazig University hospital, department of Internal medicine, Zagazig university. They included 41 males and 19 females with a mean age of5L6±10.7 years.The present work was performed to study the relation between serumascites albumin concentration gradient (SAAG), and portal hypertension with its main complication, the esophageal varices , as regard their presence and grade, then to study the effect of different treatment modalites as propranolol alone oriso-sorbide-5- mono nitrate alone or combination therapy on SAAG,portal hypertension and esophageal varices.The patients were classified into 4 groups, each group included 15 patients. Patients of group I received no drugs (control group), patients of group II received propranolol at a dose of about 40 rng t.d.s titrated gradually to decrease resting pulse by 20-25% of original, for 3 months, patients of group ill receivediso sorbide -5- mono nitrate in a dose titrated gradually to reach about 40 mg b.i.d, for 3 months and patients of group IV received both drugs for the same period.All patients were subjected to routine clinical assessment and laboratory Investigations including serwn and ascities albumin measuring, Doppler ultrasonography on the portal vein and upper GIT endoscopy, before and after 3 months (the period of treatment).