The etiology of upper gastrointestinal bleeding in patients with liver cirrhosis

Czech version

Authors: P. Svoboda ¹; J. Ehrmann ²; P. Klvaňa ¹; E. Machytka ¹; M. Rydlo ¹; V. Hrabovský ¹
Authors‘ workplace: Interní klinika FN Ostrava, přednosta doc. MUDr. Arnošt Martínek, CSc. ¹; II. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Vlastimil Procházka, Ph. D. ²
Published in: Vnitř Lék 2007; 53(12): 1274-1277
Category: Original Contributions

Overview

108 patients suffering from the cirrhosis of the liver and acute bleeding into the upper digestive tract underwent a prospective endoscopic examination with diagnostic and therapeutic objectives. The most frequent causes of acute bleeding included oesophagus varices (57.4 %) followed by peptic gastric ulcer (13.9 %) and peptic ulcer of duodenum (11.1 %), then portal hypertension gastropathy (5.6 %), gastric varices (4.6 %), reflux oesophagitis (2.8 %), Mallory-Weiss syndrom (2.8 %) and erosive gastropathy (0.9 %). The endoscopy of the upper digestive tract in one patient resulted in negative diagnosis. 69 % of examinations showed multiple findings in the upper digestive tract, each of which could have been a potential cause of bleeding. To determine the source of bleeding the specialist´s attitude presented at the end of the endoscopic examination was taken into consideration. In 67.6 % of patients the bleeding was a direct consequence of portal hypertension, in 62 % it was caused by varices. The emphasis is put on early and thorough endoscopic examinations aimed at proper diagnosis and therapy.

Key words:
cirrhosis of the liver - portal hypertension - acute bleeding - peptic ulcer -endoscopy

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