BIOCHEMICAL AND ENDOSCOPIC EVALUATION OF UPPER-GASTROINTESTINAL BLEED IN PATIENTS WITH LIVER CIRRHOSIS

  • Zubia Jamil Foundation University Medical College, Islamabad Pakistan
  • Omar Ahsan Foundation University Medical College, Islamabad Pakistan
  • Qurat Ul Ain Fauji Foundation Hospital Rawalpindi Pakistan
  • Maryam Malik Fauji Foundation Hospital Rawalpindi Pakistan
Keywords: Esophageal and gastric varices, Gastrointestinal Haemorrhage, Liver disease, Portal hypertension

Abstract

Objectives: Evaluating the causes of UGIB, their relation with Child-Turcotte-Pugh (CTP) score and biochemicalmarkers and the predictors of varices.

Study Design: Prospective comparative study.

Place and Duration of Study: Fauji Foundation Hospital Rawalpindi, from Jan 2016 to Jul 2017.

Methodology: The study population consisted of 256 patients with chronic liver disease who underwent upper gastrointestinal endoscopy to evaluate the cause of UGIB. Both variceal and non-variceal causes were notified. The patients were classified into class A, B and C according to CTP score. The relationship of varices with CTP score and biochemical findings were studied. The predictors of varices were also found by regression analysis.

Results: Gastroesophageal varices were present in 73.6% patients and 26.3% patients had non-variceal bleeding. Portal hypertensive gastropathy was the most common cause of non-variceal bleeding (20.5%). The presence and grades of varices were associated with CTP score (p<0.05). Class C had more advanced varices compared to Class A. Low platelets and albumin while high bilirubin, PT, INR and CTP class were prognosticators of varices.

Conclusion: Although a substantial portion bleeds due to variceal haemorrhage, non-variceal causes of UGIB were also not uncommon. Both pathologies resulted in substantial mortality. The advanced liver cirrhosis was associated with higher grades of varices. Blood chemistry markers helped in differentiating the two causes and manage them accordingly.

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Published
2019-10-23
How to Cite
Jamil, Z., Ahsan, O., Ain, Q., & Malik, M. (2019). BIOCHEMICAL AND ENDOSCOPIC EVALUATION OF UPPER-GASTROINTESTINAL BLEED IN PATIENTS WITH LIVER CIRRHOSIS. PAFMJ, 69(5), 1103-10. Retrieved from https://pafmj.org/index.php/PAFMJ/article/view/3422
Section
Original Articles