BLEEDING MUCOSAL LESIONS IN THE UPPER GASTROINTESTINAL TRACTS OF PATIENTS WITH OESOPHAGEAL VARICES and HEPATIC CIRRHOSIS

1976 ◽  
Vol 46 (3) ◽  
pp. 202-205
Author(s):  
I. G. Hislop ◽  
Pauline Hall ◽  
A. Kerr Grant
Keyword(s):  
Hepatic Cirrhosis ◽  
Oesophageal Varices ◽  
Mucosal Lesions ◽  
Upper Gastrointestinal

scholarly journals Epidemiology of upper gastrointestinal bleeding and Helicobacter pylori infection: review of 3,488 Thai patients

2017 ◽  
Vol 9 (1) ◽  
pp. 87-93
Author(s):  
Sakolwan Suchartlikitwong ◽  
Kamolyut Lapumnuaypol ◽  
Rungsun Rerknimitr ◽  
Duangporn Werawatganon
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Helicobacter Pylori Infection ◽  
Exclusion Criteria ◽  
Common Causes ◽  
Mucosal Lesions ◽  
H Pylori ◽  
Upper Gastrointestinal

Abstract Background The current epidemiology of upper gastrointestinal bleeding (UGIB) in Thailand is poorly understood and the reported prevalence of Helicobacter pylori infection is outdated. Objectives To investigate the etiologies of UGIB and prevalence of H. pylori infection in Thailand, including its association with UGIB. Methods We retrieved information regarding patients attending the endoscopic unit of King Chulalongkorn Memorial Hospital from June 2007 to January 2013. A database search using keywords “upper gastrointestinal bleeding” and “iron deficiency” was used. From 4,454 diagnoses, after exclusion criteria, 3,488 patients (2,042 male (58.5%) and 1,446 female (41.5%); mean age 63.3 ± 15.94 years, range 13–103 years) were included. Results The three most common causes of UGIB were peptic ulcer (38.2%), nonulcer-mucosal lesions (23.4%), and esophageal-related causes (20.4%). The 5 year-incidence of H. pylori was 25%–30%. The overall prevalence was 27%. The prevalence of H. pylori infection was found to decrease with age from 43.8% at <40 years to 21.7% at >79 years old. H. pylori infection was significantly associated with duodenal and gastroduodenal ulcers. Cirrhosis and nonulcer-mucosal lesions were significantly unrelated to H. pylori infection. Patients with concurrent cirrhosis with peptic ulcer were found to be negative for H. pylori infection. Conclusion Peptic ulcer is the leading cause of UGIB in Thailand. However, its incidence is declining. Patients who presented to hospital with UGIB were older, compared with those a decade ago. H. pylori infection plays an important role in UGIB and its incidence was stable during the past 5 years.

scholarly journals Diagnosis and management of extrahepatic oesophageal variceal bleed in children in a low resourced setting

2020 ◽  
Vol 54 (4) ◽  
pp. 274-278
Author(s):  
Taiba J. Afaa ◽  
Kokou H. Amegan-Aho ◽  
Elikem Richardson ◽  
Bamenla Goka
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Upper Gastrointestinal Bleeding ◽  
Liver Function Tests ◽  
Tertiary Hospital ◽  
Secondary Prophylaxis ◽  
Resource Constraint ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal

Extrahepatic portal vein obstruction (EHPVO) is a major cause of portal hypertension (PH) in children. Portal vein thrombosis (PVT) is the most common cause accounting for up to 75% of cases in developing countries. Upper gastrointestinal bleeding is the most dreaded and commonest presentation of portal hypertension. Successful treatment of paediatric PH, though challenging is performed in resource constraint countries. Cases: Five children presented over three years to a tertiary hospital in Ghana, with massive upper gastrointestinal bleeding. They had anaemia, thrombocytopaenia and four had splenomegaly. Liver function tests, INR, haemoglobin electrophoresis as well as HIV serology, hepatitis B and C screening were all normal. Abdominal doppler ultrasound scan confirmed portal vein thromboses. They were resuscitated and managed with octreotide, propranolol, antibiotics and sclerotherapy or oesophageal variceal banding in the acute setting and long term secondary prophylaxis with propranolol. Subsequently, an algorithm was developed to assist with the management of bleeding from oesophageal varices and the diagnosis of EHPVO. Conclusion: Portal hypertension due to EHPVO is an important cause of upper gastrointestinal (GI) bleeding in children. This can be successfully managed even in a resource constraint setting once the appropriate measures are taken.

scholarly journals Maternal and Fetal Outcomes of Pregnant Women with Hepatic Cirrhosis

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Harun Egemen Tolunay ◽  
Mesut Aydın ◽  
Numan Cim ◽  
Barış Boza ◽  
Ahmet Cumhur Dulger ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Esophageal Varices ◽  
Hepatic Cirrhosis ◽  
Morbidity And Mortality ◽  
Decompensated Cirrhosis ◽  
Band Ligation ◽  
Compensated Cirrhosis ◽  
The Mean ◽  
Upper Gastrointestinal

Aim. The reproductive hormone levels and systemic physiology of women with hepatic cirrhosis are altered. Existing data have indicated the adverse effects of cirrhosis on both the mother and the fetus. Pregnancy is successful in most of the patients with chronic liver disease. But maternal and fetal complication rates are still high for decompensated hepatic cirrhosis. In this study, we aimed to evaluate the clinical features, etiological factors, medications, morbidity, mortality, and obstetric outcomes of pregnant women with hepatic cirrhosis. Methods. Pregnant women, who were diagnosed with maternal hepatic cirrhosis and followed up in our clinic between 2014 and 2017, were retrospectively evaluated. The pregnant women that had been followed up for hepatic cirrhosis were classified as compensated disease and decompensated disease. Eleven cases were included in this period. Results. The mean age of cases was 33.5±5.5 years. The mean gravida number was 3.2±1.1, and the mean parity number was 1.7±1. Six cases were in the compensated cirrhosis stage, and 5 cases were in the decompensated cirrhosis stage. A pregnancy with decompensated cirrhosis was terminated after the fetal heart sound was negative in the 9th week of pregnancy. Spontaneous abortus occurred in one case (<20 weeks). The mean gestational week of the 9 cases was 33.3±6.2. Two of the 9 cases delivered birth vaginally. Seven cases delivered by cesarean section. The mean first- and fifth-minute APGAR scores were 6.6±1.41 and 8.2±1.56, respectively. The mean birth weight was 2303±981 g. Among 9 cases with live birth, 6 had compensated cirrhosis and 3 had decompensated cirrhosis. In the second trimester, upper gastrointestinal endoscopy was performed to all patients in terms of esophageal varices. Endoscopic band ligation was performed in 3 cases with upper gastrointestinal bleeding. The postpartum mortality did not occur. Discussion. Pregnancy is not recommended for patients with hepatic cirrhosis due to high maternal and fetal morbidity and mortality. The pregnancy course of cases with cirrhosis changes according to the stage of liver injury and severity of disease. Although the delivery method is controversial, delivery by cesarean section is recommended for patients with esophageal varices by the reason of bleeding from varices after pushing during labor. The bleeding risk must be kept in mind as coagulopathy is common in hepatic diseases. The maternal-fetal morbidity and mortality rates have been decreased by the current developments in hepatology, prevention of bleeding from varices with drugs and/or band ligation, improvement in liver transplantation, and increasing experience in this issue.

Bleeding Colonic Varices Controlled by Propranolol

1988 ◽  
Vol 33 (6) ◽  
pp. 370-371 ◽  
Author(s):  
L.G. McAlpine ◽  
G.G. Birnie ◽  
T.E. Hilditch ◽  
J.H. Dagg
Keyword(s):  
Gastrointestinal Bleeding ◽  
Radionuclide Imaging ◽  
Hepatic Cirrhosis ◽  
Oesophageal Varices ◽  
Ascending Colon ◽  
Severe Haemorrhage ◽  
Colonic Varices ◽  
A Site ◽  
Oral Propranolol

A 64-year-old man with hepatic cirrhosis developed severe haemorrhage from oesophageal varices. He underwent a course of sclerotherapy injections which successfully obliterated the oesophageal varices and prevented further oesophageal bleeding. He later developed serious bleeding from a site in the region of the ascending colon; angiography and radionuclide imaging suggested that varices were present in that region. Therapy with oral propranolol was effective in preventing any recurrence of gastrointestinal bleeding.

scholarly journals Giant Left Atrium - A Rare Case of Acute Upper Gastrointestinal Bleeding

2016 ◽  
Vol 54 (201) ◽  
pp. 40-42
Author(s):  
Khus Raj Dewan ◽  
Bhanumati Saikia Patowary ◽  
Subash Bhattarai
Keyword(s):  
Left Atrium ◽  
Upper Gastrointestinal Bleeding ◽  
Medical Emergency ◽  
Oesophageal Varices ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Giant Left Atrium ◽  
Upper Gastrointestinal

Acute upper GI bleeding is a common medical emergency with a hospital mortality of approximately10%. Non variceal UGI bleeding is the most common cause followed by oesophageal varices. Variousrare causes have been described in the literature but there are very few cases of giant left atriumleading to oesophageal erosion and causing upper GI bleeding. We are presenting a case of rheumaticvalvular heart disease with giant left atrium who presented in our department with acute upper GIbleeding. Keywords: giant left atrium;oesophgeal erosion; upper GI bleeding. | PubMed

scholarly journals An anomalous engenderment of a common scenario: upper gastrointestinal bleeding

2017 ◽  
Vol 6 (1) ◽  
pp. 362
Author(s):  
Tirth Nayan Vasa ◽  
Mukhayprana Prabhu ◽  
Rajagopal K. V. ◽  
Devavrata Sahu ◽  
Harnish Bhatia
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Rapid Assessment ◽  
Visceral Artery ◽  
Oesophageal Varices ◽  
Early Management ◽  
Ulcer Disease ◽  
Risk Of Rupture ◽  
Visceral Artery Aneurysms ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding (UGIB) includes hemorrhage originating from the esophagus to the ligament of Treitz. It is a gastrointestinal emergency that can result in significant morbidity, mortality, along with laborious utilization of health-care resources. With the advent of definite management protocols, the recent trends have revealed that patients rarely die from exsanguination, with decompensation of the underlying disorders, rather, proving to be causative of the same. Rapid assessment, resuscitation, and early endoscopic investigation serve as the foundation of early management. Common sinister underlying aetiology include Oesophageal Varices, Peptic Ulcer Disease, NSAID Induced Acute Gastritis or Malignancy. Arising from a conglomeration of aetiologies, an infrequent one, is a silently sinister pseudoaneurym rupturing into the stomach, stemming from a visceral artery. Since the first description by Beaussier in 1770, the condition has been detected with increasing frequency, primarily as a consequence of the increasing use of accurate imaging methods. Coeliac artery aneurysms (CAAs) occur in approximately 0.2% of the overall population and constitute approximately 4% of all visceral artery aneurysms (VAAs). Their risk of rupture is estimated at 10% to 15% and is associated with high mortality. Associated risk factors include atherosclerosis, hypertension, systemic inflammation, trauma, collagen vascular disease, infection, fibromuscular dysplasia, and cirrhosis

224 PREDICTION OF OESOPHAGEAL VARICES (OV) IN HEPATIC CIRRHOSIS BY SERUM NON-INVASIVE MARKERS: RESULTS OF A MULTICENTER, INTERNATIONAL STUDY

2009 ◽  
Vol 50 ◽  
pp. S91
Author(s):  
G. Sebastiani ◽  
A. Alberti ◽  
L. Castera ◽  
G. Fattovich ◽  
P. Halfon ◽  
...  
Keyword(s):  
Hepatic Cirrhosis ◽  
International Study ◽  
Oesophageal Varices ◽  
Non Invasive
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