الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
SUMMARY UMMARYUMMARYUMMARYUMMARY
Approximately 8 % of patients with liver cirrhosis without varices develop varices de novo each year,it is estimated that the ma-jority of cirrhotic individuals will develop varices during their life time. Eugene R. Schiff et al., 2011.
All cirrhotic patients without a history of variceal hemorrhage sh-ould undergo endoscopic screening to detect prescence of varices. Madhotra et al., 2002.
There is significant burden and cost on endoscopy unites for dete-ction of varices, also patients having repeated unpleasant procedure-s even when up to 50% may still not have developed esophageal varices 10 years after the intial diagnosis. M. Merli et al., 2009.
Serotonin is known as 5-hydroxytryptamine (5-HT), a biogenic a-mine that functions as a ligand for a large family of 5-HT receptors,T-he majority of serotonin in the body (90%) is synthesised by entero-chromaffin cells of the gastrointestinal(GI) tract, where it regulates intestinal motility. Gershon MD et al., 2007.
With respect to the liver, it was found that serotonin has the abili-ty to regulate hepatic blood flow at both the portal and sinusoidal le-vels. Ruddel RG et al., 2011.
Intraportal injections of serotonin were found to signintly
increased portal pressure, this suggests that serotonergic mechanis-ms may contribute to maintaining portal hypertension in patients with cirrhosis, Mabuchi A et al., 2004.
This study was conducted in internal medicine department, Ain Shams Universityduring the period from October 2014 to July 2015 to investigate the role of serotonin in development of esophageal and gastric fundal varices as a result of increased portal pressure due to its vasoactive effect.
Eighty patients with HCV related cirrhosis 63 were males (78 %) &17 were females (22%),20 healthy volunteers 6 females (30%) &14 males (70%) used as control group divided into two groups according to the prescence of O.Vs and twenty healthy controls were included in this study. All patients of the study were subjected to pelvi-abdominal ultrasound, upper GI endoscopy & serum serotonin level beside other routine investigations.
Gastric varices was detected in 20%of patients, OV grade I was detected in15% of patients, OV grade II in 50%, OV grade III in 35%of patients, while We confirmed the previous reports of increased serum serotonin in patients with liver cirrhosis.
Our results also verified that, the mean plasma free serotonin level was higher in patients with esophageal varices than in patients without varices. Furthermore, the correlation of plasma serotonin concentration and fundal varices was highly significant.
Our conclusion was that free serotonin is significant in detetction of prescence of varices especially in development of gastric fundal varices.