Non-Cirrhotic Portal Hypertension: A Case of Bleeding Gastro-Oesophageal Varices with Non-Cirrhotic Liver Reported in East Malaysia

Authors

  • Alvin Oliver Payus
  • Justin Leow Wen Hsiang
  • Liew Sat Lin
  • Malehah Mohd Noh

DOI:

https://doi.org/10.51200/bjms.v13i1.1228

Keywords:

Non-Cirrhotic Portal Hypertension, normal liver, variceal bleeding

Abstract

Non-cirrhotic portal hypertension (NCPH) is clinically defined as the presence of portal hypertension in the background of non-cirrhotic liver. It is diagnosed by the findings in ultrasound of the hepatobiliary system and also oesophagogastroduodenoscopy (OGDS) that consistent with that of a portal hypertension, but otherwise has a relatively normal liver function and echotexture. The treatment mainly focuses on primary and secondary prophylaxis of variceal bleeding both pharmacologically like non-selective beta-blockers and octreotide, and non-pharmacologically like endoscopic band ligation of varices and sclerotherapy. In advance cases, sometimes surgery such as Porto-systemic shunt or splenectomy may be required especially in patients with uncontrolled variceal bleeding or with symptomatic hypersplenism. Here we report a case of a young man who presented with upper gastro-intestinal bleeding, which was initially thought from a bleeding ulcer but was found to be secondary to oesophageal and gastro-oesophageal varices. Apart from having mild ascites, he has no other features of portal hypertension. His liver biochemistry and echotexture were also normal. Unfortunately, the patient was lost to follow up while he was still in the early stage of investigating the condition. The purpose of this case report is to share an uncommon occurrence of NCPH in East Malaysia, where liver cirrhosis predominates the aetiology of portal hypertension. Also, to the best of our knowledge, there is a very limited reporting of a similar case in this region.

Author Biographies

Alvin Oliver Payus

Medicine Based Department,

Faculty of Medicine and Health Science,

Universiti Malaysia Sabah,

Kota Kinabalu, Sabah, Malaysia

Justin Leow Wen Hsiang

General Medicine Department,
Queen Elizabeth Hospital,
Kota Kinabalu, Sabah, Malaysia

Liew Sat Lin

Medicine Based Department,

Faculty of Medicine and Health Science,

Universiti Malaysia Sabah,

Kota Kinabalu, Sabah, Malaysia

Malehah Mohd Noh

Medicine Based Department,

Faculty of Medicine and Health Science,

Universiti Malaysia Sabah,

Kota Kinabalu, Sabah, Malaysia

 

Published

2019-01-29

How to Cite

Payus, A. O., Hsiang, J. L. W., Sat Lin, L., & Mohd Noh, M. (2019). Non-Cirrhotic Portal Hypertension: A Case of Bleeding Gastro-Oesophageal Varices with Non-Cirrhotic Liver Reported in East Malaysia. Borneo Journal of Medical Sciences (BJMS), 13(1), 33. https://doi.org/10.51200/bjms.v13i1.1228
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