Publication: The Etiology of Upper Gastrointestinal Bleeding in Patients with Liver Cirrhosis in Dhulikhel Hospital
Date
2017
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Acute upper gastrointestinal bleeding is a serious medical problem in cirrhotic
patients. Patients with cirrhosis may develop upper gastrointestinal bleeding
from a variety of lesions, including those due to portal hypertension, namely
gastroesophageal varices and portal hypertensive gastropathy and other lesions as
seen in the general population.
Objective
To investigate the etiology of upper gastrointestinal bleeding in liver cirrhotic patients.
Method
A retrospective review of 72 patients with liver cirrhosis and upper gastrointestinal
bleeding from January 2013 to March 2016 was carried out at Dhulikhel Hospital.
Child Pugh score was used to assess severity. Endoscopic diagnosis was documented.
Result
Out of 72 patients, 56 (77.8 %) were male and 16 (22.2%) were female. The most
common age group was 30-42 years age. Fifty four cases of cirrhosis were associated
with alcohol consumption. The Child-Pugh score was A in 20 patients (27.8%), B in 15
patients (20.8%) and C in 37 patients (51.4%). A combination of alcohol consumption
and HCV infection was significantly associated with a higher Child-Pugh score
(p=0.031). Twenty six (36.11%) patients had esophageal varices as cause of bleeding
on endoscopic examination while 29(40.28%) had varices and other lesions identified
at endoscopy. Of these 29 patients, 18 were found to have bled from esophageal
varices, and 11 were found to have bled from coexisting lesion.
Conclusion
We found that variceal bleeding was the commonest cause of bleeding in cirrhotic
patients, with 55 (78.5%) having varices and 44 (61%) actually bleeding from varices.
KEY WORDS
Alcohol, Cirrhosis, Endoscopy, Non-variceal upper gastrointestinal hemorrhage,
Variceal bleeding
Description
Purbey BK, Gurung RB, Panday R, Acharya B, Mehta RK
Department of Internal Medicine
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre Nepal
Keywords
Alcohol, Cirrhosis, Endoscopy, Non-variceal upper gastrointestinal hemorrhage, Variceal bleeding