Post Banding Ulcer Haemorrhage: a Contributor to Morality in Patients with Liver Cirrhosis

Authors

  • Shahida Perveen Department of Medicine, Foundation University School of Health Sciences (FUSH), Islamabad Pakistan
  • Omar Ahsan Department of Medicine, Foundation University School of Health Sciences (FUSH), Islamabad Pakistan
  • Batool Butt Department of Medicine, Foundation University School of Health Sciences (FUSH), Islamabad Pakistan
  • Atif Abbas Department of Medicine, Fauji Foundation Hospital, Rawalpindi Pakistan
  • Sehrish Jahan Asif Department of Medicine, Fauji Foundation Hospital, Rawalpindi Pakistan
  • Syeda Fatima Hassan Department of Pulmonology, Shaafi International Hospital, Islamabad

DOI:

https://doi.org/10.51253/pafmj.v73i6.8835

Keywords:

Endoscopy, Endoscopic variceal band ligation (EVBL), Model for end-stage liver disease score, Post banding ulcer haemorrhage

Abstract

Objectives: To evaluate the frequency, risk factors and mortality of post-banding bleeding in cirrhosis.

Study Design: Retrospective longitudinal Study.

Place and Duration of Study: Department of Medicine, Fauji Foundation Hospital, Rawalpindi Pakistan, from Feb to Jul 2021.

Methodology: Esophageal variceal band ligation (EVBL) was done in 123 patients. The study cohort was divided into two
groups: Group-1 without re-bleed and Group-2 with re-bleed. Blood chemistry, Child-Pugh and MELD score, including the
indications of EVBL and risk factors, were also analysed. Regression analysis was performed.

Results: Re-bleed occurred in 10.6% (n=13) of patients. The mean duration between ligation and re-bleed was 8.75±2.8 days. Oesophageal ulcers were the most common cause of re-bleeding (38.5%). Mortality rates among the two groups were 21.8 %( n=24) and 30.8 %( n=4), respectively. The model for end-stage liver disease score (OR 2.177, CI 1.069-4.43, p .03), APTT (OR 0.593, CI 0.397-0.887, p .01) and Sodium (OR 1.345, CI 1.07-1.69, p<0.01) were detected as the predictors of re-bleed.

Conclusion: Although re-bleeding after banding occurs in a trivial number of patients, it contributes to mortality.
Coagulopathy, high sodium and MELD score are major predictors.

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Published

30-12-2023

How to Cite

Perveen, S., Ahsan, O., Butt, B., Abbas, A., Asif, S. J., & Hassan, S. F. (2023). Post Banding Ulcer Haemorrhage: a Contributor to Morality in Patients with Liver Cirrhosis. Pakistan Armed Forces Medical Journal, 73(6), 1720–1724. https://doi.org/10.51253/pafmj.v73i6.8835

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