DefinePK

Abstract

DISCUSSION


99mTc-Sn colloid scintigraphy was found to be a simple and rapid method of differentiating cirrhosis from IPH. The results of the present study are in accordance with our previous findings8. Being a comparatively less invasive test than liver biopsy, its usefulness would be enhanced in cases where liver biopsy is contraindicated or difficult to perform (Massive ascites, altered coagula­tion profile, small shrunken liver and patient’s reluc­tance to undergo biopsy). 1PM is a very well recognized clinical entity in Japan9 and India11 but is very infrequent in the western countries12. Although the actual frequen­cy of IPH is not known in Pakistan but with the increasing awareness of this disease entity, lot of new patients are being diagnosed. Unlike cirrhosis where liver is diseased, liver in 1PM is almost normal, therefore the disease runs a protracted course with good prognosis13-16 and has a high survival rate (87%)17 following leinorenal shunt and sclerotherapy (100%)15. In view of good prognosis in IPH there is a need to diagnose and treat these cases as early as possible; this further accentuates the need to properly identify these cases, for which scintigraphy technique may be used initially to differentiate cirrhosis from noncirrhotic group and once diagnosed, patients with 1PM may be subjected to further tests to confirm the diagnosis. Of the various pathophysiological parameters evaluated, histology followed by clinical diagnosis showed a good correlation to the ratio of the slope of integral.