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  • Title: Symptomatic hepatic disease in cystic fibrosis: incidence, course, and outcome of portal systemic hunting.
    Author: Stern RC, Stevens DP, Boat TF, Doershuk CF, Izant RJ, Matthews LW.
    Journal: Gastroenterology; 1976 May; 70(5 PT.1):645-9. PubMed ID: 1083350.
    Abstract:
    Fifteen (2.2%) of 693 patients with cystic fibrosis seen over an 18-year period developed clinical hepatic disease. In 13 patients all symptoms were secondary to portal hypertension. Ten had hypersplenism and 6 had variceal bleeding, including 3 who developed both conditions. All 5 patients who survived the initial episode of gastrointestinal bleeding underwent portal systemic shunting. A shunting procedure also was performed on 1 patients with hypersplenism but no variceal bleeding. No subsequent deterioration of intellectual function occurred in either the shunted or unshunted patients. Only 1 of the shunted patients showed progression of hepatic disease after surgery. These results suggest that portal systemic shunting is useful in the treatment of bleeding esophageal varices in cystic fibrosis. A sweat test to rule out cystic fibrosis should be included in the evaluation of any teenage or young adult patient with unexplained portal hypertension.
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