الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Portal hypertensive patients are frequently admitted at Mansoura Gastro-enterology Center for surgical management of their problem either for shunt (S) or Hassab (H) operations. Marked haemodynamic and oxygenation alterations were recorded for this type of patients. Forty patients were studied (four groups-each of ten). Patients were anaesthestized either by general (G) or epiduraVgeneral (EG) techniques (SG, SEG, HG & HEG groups), parameters were monitored through pulmonary artery and arterial catheters, analysis of arterial and mixed venous blood gases and Hb%, all data were recorded before and 30 min. after induction of anaesthesia, after surgical procedure and at recovery. Results demonstrated that portal hypertension in Egyptian patients is mainly due to combined schistosomal and hepatitis etiology (70% of patients). Pre-operative investigations revealed near normal values with low platlet count, and mild anaemia.
Basal haemodynamics demonstrated that these patients could have mild hyperdynamic circulationry state with high CI and low SVRI, there was a high incidence of pulmonary hypertension (15% had MP AP >30 mmHg) which is higher than reported value (2%). PVRI was normal which is contradictory to known decrease in tins value in cirrhotic patients.
Basal oxygenation data showed adequate Pa02 and Sa02 there was also high Pv02 and Sv02 with low ER02 and (a-v) 02’ that may be attributed to (a-v) shunting.
Porto-systemic shunting added an early dynamic load upon pulmonary circulation with increased PCWP, MPAP, RVSWI and LVSWI in shunt.