Upper gastrointestinal bleeding in patients with liver cirrhosis

Schäfer, Eszter; Rusznyák, K; Visnyei, Z; Dunkel, Kinga; Tolmácsi, B; Szamosi, T; Czegledi, Zsofia; Varsányi, M; Nádas, B; Csizmazia, I; Tolvaj, Gyula; Rábai, K; Zsigmond, F; Gyökeres, T; Banai, J

doi:10.1055/s-0031-1278507

Cited by 2 publications

(3 citation statements)

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“…Several studies report similar results. 14,15,16,19,23 Bleeding esophageal varices was the most common endoscopic finding, which was consistent with most other studies 16 Three western studies 21,23,24 found PHG as the most common non-variceal cause of bleeding, which is similar to our study. Different studies found gastric varices ranging from 8.3% to 9.4%.…”

Section: Discussionsupporting

confidence: 92%

“…The vast majority (75%) of cases of cirrhosis were due to HCV, which was comparable to some 16 , however it contradicts the many western studies in which alcohol is the most common cause of cirrhosis. 19,20,21,22 Majority (83%) of our cirrhotic patients with AUGIB have advanced liver disease (CTP B or C), indicating that severity of disease is a risk factor for AUGIB. Several studies report similar results.…”

Section: Discussionmentioning

confidence: 95%

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Frequency of fundal varices in cirrhotic patients with upper gastrointestinal bleed.

Malghani

Chaudhary

Din

et al. 2019

TPMJ

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Objectives: Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency in cirrhosis. These patients mainly bleed from esophageal varices. The aim of the present work was to determine the prevalence of fundal varices; gastro-oesophageal varices type2 (GOV-2) and isolated gastric varices type1 (IGV-1), as a cause of AUGIB. Study Design: Cross-sectional study. Setting: Gastroenterology Department of Nishtar Hospital Multan, Pakistan, using non-probability consecutive sampling. Period: July to December 2018. Material and Methods: Emergency upper gastrointestinal (UGI) endoscopy was performed in 165 cirrhotic patients and the findings documented. Results: The mean age was 50.15 ± 12.72 years. There were 103 (62.4%) males and 62 (37.6%) females (p<0.0001). Hepatitis C virus (HCV) was the cause of cirrhosis in 75%, followed by HBV in 10% and HBV & HCV co-infection in 6%. Bleeding fundal varices were found in 25 (15%) patients, 15 IGV-1 and 10 GOV-2. Other major causes of bleeding included: esophageal varices 93 (56.4%) and portal hypertensive gastropathy (PHG) 33 (20%). All fundal varices were found in advanced liver disease patients (p<0.05). Conclusion: AUGIB is more common in males and advance liver disease. Although not frequent, fundal varices are an important cause of AUGIB, with a strong association with severity of cirrhosis. Our study demonstrates a higher prevalence of fundal varices (especially IGV-1) than other studies.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Frequency of fundal varices in cirrhotic patients with upper gastrointestinal bleed.

Malghani

Chaudhary

Din

et al. 2019

TPMJ

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“…1 Usually, the patient with this disease need to be hospitalized due to several complications, including upper gastrointestinal bleed, Spontaneous bacterial peritonitis (SBP), tense ascites, hepatopulmonary syndrome (HPS), Hepatocellular carcinoma (HCC), hepatic encephalopathy and Hepatic hydrothorax. 6,7 It is seen that due to these complications, the hospital mortality rate of liver cirrhosis patients ranges from 13.5% to 35% worldwide, which is very high. 8 Of these, hepatic encephalopathy is the major one; it features significant neuropsychiatric disturbances in response to liver dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Tracheobronchial aspiration affects the outcome of hospitalization among Hepatic Encephalopathy patients

Rafiq

Zeeshan²,

Mustafa

et al. 2022

Pak J Med Sci

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Objectives: The present study aimed to determine the effect of tracheobronchial aspiration on hospitalization outcomes and the factors influencing its occurrence. Methods: This prospective descriptive study was conducted from January 2017 to December 2020 at GMC/DHQ-Teaching Hospital in Gujranwala, Pakistan. All consenting liver cirrhosis patients with hepatic encephalopathy > 12 years of age admitted at the study site were included. The patient’s baseline characteristics and the hospitalization outcomes were noted in terms of death and discharge. The collected data was analyzed using SPSS version 22.0. The predictors of tracheobronchial aspiration were determined using Independent Sample T test and Chi-square test for quantitative and qualitative variables respectively. The p-values were taken statistically significant if < 0.05. A binary logistic regression analysis was performed to ascertain the effect of significant factors on the likelihood of tracheobronchial aspiration. Results: Among the total of 294 patients, 28.0% died during hospitalization. Death occurred significantly more in group of patients who had tracheobronchial aspiration (62.7% vs 12.0%, p<0.01). Increasing age was associated with increased chance of tracheobronchial aspiration (p<0.01). Male gender (49.6% vs 8.2%, p<0.01), patients whose hepatic encephalopathy was precipitated by upper GI bleed (59.7% vs 22.9%, p<0.01), and patients with comorbidities (p=0.02) were significantly prone to tracheobronchial aspiration. Conclusions: Tracheobronchial aspiration is a significant predictor of inpatient mortality among patients with hepatic encephalopathy. Male gender, increasing age & upper GI bleed predict aspiration in hepatic encephalopathy patients. doi: https://doi.org/10.12669/pjms.38.4.5114 How to cite this:Rafiq Q, Zeeshan M, Mustafa G, Irfan M. Tracheobronchial aspiration affects the outcome of hospitalization among Hepatic Encephalopathy patients. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5114 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Upper gastrointestinal bleeding in patients with liver cirrhosis

Cited by 2 publications

References 0 publications

Frequency of fundal varices in cirrhotic patients with upper gastrointestinal bleed.

Frequency of fundal varices in cirrhotic patients with upper gastrointestinal bleed.

Tracheobronchial aspiration affects the outcome of hospitalization among Hepatic Encephalopathy patients

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