[Diagnosis and therapy of portal hypertension with special reference to endoscopic methods]

The GI endoscopy can be divided into upper GI tract endoscopy (oesophago-, gastro-, entero-, fistulo- and cholangioscopy) and lower GI tract endoscopy (recto-, sigmo-, colonoscopy) from practical point of view and the characteristic of used equipment. A lot of therapeutic methods for GI tract is associated with each of these procedures. GI tract endoscopy doesn't play significant part in diagnosis of acute and chronic hepatitis. Significance of endoscopy procedures decidedly increases in the case of progressive liver fibrosis and liver cirrhosis, where changes in GI tract are observed to 87% patients. These changes can be divided into: 1) not associated with portal hypertension, 2) these ones caused by portal hypertension. The most observed changes not associated with portal hypertension involve: reflux esophagitis, esophageal candidiasis; different variants of gastritis, gastric and duodenal ulcer. To the changes connected with portal hypertension, which are possible for endoscopy assessment, belongs esophageal and gastric varices, portal gastro-, entero-, colopathy, and gastric antral vascular ectasiae (GAVE). However to-day endoscopy has got not only diagnostic significance but also enables therapy of acute GI bleeding in this group of patients., the primary and secondary prophylaxis of bleedings from GI varices (particulary endoscopy band ligation-EBL) as well as estimation of pharmaco- and surgical therapy efficiency.