ROLE OF SEROTONIN IN DETECTION OF OESOPHAGEAL AND FUNDAL VARICES

Abstract

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. Schiffet 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. Serotoninis 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 MDet 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 RGet al., 2011. Intraportal injections of serotonin were found to signintlyincreased portal pressure, this suggests that serotonergic mechanis-ms may contribute to maintaining portalhypertension in patients with cirrhosis, Mabuchi Aet 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 vasoactiveeffect. Eightypatients with HCV related cirrhosis 63 were males (78%) &17 were females (22%),20 healthy volunteers 6 females (30%) &14 males (70%) used as control groupdivided into two groups according to the prescence of O.Vs and twenty healthy controls were included inthis 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, whileWe confirmed the previous reports of increased serum serotonin in patients with liver cirrhosis.