scholarly journals CLINICAL UTILITY OF RISK SCORES IN VARICEAL BLEEDING

2019 ◽  
Vol 56 (3) ◽  
pp. 286-293
Author(s):  
Sanjay CHANDNANI ◽  
Pravin RATHI ◽  
Suhas Sudhakarrao UDGIRKAR ◽  
Nikhil SONTHALIA ◽  
Qais CONTRACTOR ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Variceal Bleeding ◽  
Risk Scores ◽  
Gastrointestinal Bleed ◽  
Variceal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
Serum Bicarbonate Level ◽  
Study Characteristics ◽  
Common Etiology ◽  
Upper Gastrointestinal

ABSTRACT BACKGROUND: Variceal bleeding remains important cause of upper gastrointestinal bleed. Various risk scores are used in risk stratification for non-variceal bleed. Their utility in variceal bleeding patients is not clear. This study aims to compare probability of these scores in predicting various outcomes in same population. OBJECTIVE: This study aims to compare probability of these scores in predicting various outcomes in same population. To study characteristics and validate AIMS65, Rockall, Glasgow Blatchford score(GBS), Progetto Nazionale Emorragia Digestiva (PNED) score in variceal Upper Gastrointestinal Bleed (UGIB) patients for predicting various outcomes in our population. METHODS: Three hundred subjects with UGIB were screened prospectively. Of these 141 patients with variceal bleeding were assessed with clinical, blood investigations and endoscopy and risk scores were calculated and compared to non-variceal cases. All cases were followed up for 30 days for mortality, rebleeding, requirement of blood transfusion and need of radiological or surgical intervention. RESULTS: Variceal bleeding (141) was more common than non variceal (134) and 25 had negative endoscopy. In variceal group, cirrhosis (85%) was most common etiology. Distribution of age and sex were similar in both groups. Presence of coffee coloured vomitus (P=0.002), painless bleed (P=0.001), edema (P=0.001), ascites (P=0.001), hemoglobin <7.5 gms (P<0.001), pH<7.35 (P<0.001), serum bicarbonate level <17.6 mmol/L (P<0.001), serum albumin<2.75 gms% (P<0.001), platelet count <1.2 lacs/µL (P<0.001), high INR 1.35 (P<0.001), BUN >25mmol/L (P<0.001), and ASA status (P<0.001), high lactate >2.85 mmol/L (P=0.001) were significant. However, no factor was found significant on multivariate analysis. Rockall was found to be significant in predicting mortality and rebleed. AIMS65 was also significant in predicting mortality. GBS was significant in predicting blood transfusion and need of intervention. PNED score was significant in all events except mortality. CONCLUSION: All four scores had lower predictive potential in predicting events in variceal bleed. However, AIMS65 & Rockall score were significant in predicting mortality, while GBS in predicting need of transfusion and intervention. PNED score was significant in all events except mortality.

scholarly journals Seasonal variation in acute variceal upper gastrointestinal tract bleeding: Experience of one decade from Northern India

2021 ◽  
Vol 12 (8) ◽  
pp. 76-80
Author(s):  
Shabir Ahmad Shiekh ◽  
Ali Imran ◽  
Showkat Ahmad Kadla ◽  
Mohammad Yasin ◽  
Bilal Ahmad Khan ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Demographic Data ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Gastrointestinal Bleed ◽  
Northern India ◽  
Variceal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
The World ◽  
Upper Gastrointestinal

Background: There have been several reports of seasonal variations in the incidence of esophageal variceal bleeding but the data available from this part of the world is scanty. Aims and Objective: We aimed to study whether monthly and seasonal climatic changes during the year have an influence on the incidence of variceal bleeding in our setting and whether a particular time in the year can be defined as a high-risk period for variceal bleed. Materials and Methods: Data of all the patients with diagnosis of acute variceal upper gastrointestinal bleed who presented to our endoscopy centre from January 2010 to December 2019 was retrieved and analysed. The demographic data, clinical presentations and seasonal and monthly variation was analysed. Results: Out of a total of 10200 patients presenting with upper gastrointestinal bleed during the study time period, 530 patients had a diagnosis of variceal bleed after esophagogastroduodenoscopy (EGD). The majority of variceal bleed patients (48.5%) were seen between May to August months of the year. Conclusions: Contrary to the most of the literature which shows increased frequency of variceal bleed during winters, our patients bleed more during the months of May and August. This could be explained on the basis of unique socio-cultural and demographic pattern of this part of the world.

Spectrum of upper gastrointestinal bleed in patients with cirrhosis of liver

2017 ◽  
Vol 13 (3) ◽  
pp. 318-322
Author(s):  
Subash Bhattarai ◽  
Khus Raj Dewan ◽  
Gaurav Shrestha ◽  
Bhanumati Saikia Patowary
Keyword(s):  
Liver Cirrhosis ◽  
Peptic Ulcer ◽  
Portal Hypertension ◽  
Oesophageal Varices ◽  
Gastrointestinal Bleed ◽  
Variceal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
Cirrhotic Patients ◽  
Cirrhosis Of Liver ◽  
Upper Gastrointestinal

Background & Objectives:Acute upper gastrointestinal (UGI)  bleeding is a serious medical problem in patients with cirrhosis of  liver associated with high mortality. Gastro-oesophageal variceal bleed is the most common complication of portal hypertension in patient with liver cirrhosis. This study  was undertaken to establish the causes of UGI bleed in cirrhosis, their relative incidences, clinical presentation , endoscopic findings, outcomes during hospitalization including rebleeding and mortality were studied.Materials & Methods:One hundred and twenty patients with clinical features, sonological and endoscopic evidence of portal hypertension and cirrhosis of liver who presented with upper gastrointestinal bleed were included in the study. After haemodynamic stability, each patient underwent UGI endoscopy usually within 12 hours and the aetiology with diagnostic findings were documented. Results:Ruptured oesophageal varices was the  most common cause of UGI bleed in cirrhotic patients. Non variceal causes of UGI bleed accounted for 33.3 % of cases. The majority of non variceal bleed was peptic ulcer disease and accounted for 19.2 % of total UGI bleed in liver cirrhosis. This was followed by portal hypertension gastropathy, erosive gastropathy, mallory-weiss tear and others.Conclusion:The most frequent causes of acute gastrointestinal bleeding in cirrhosis was  oesophageal varices. Peptic ulcer disesase is also a common aetiology of UGI bleed in cirrhosis. Cirrhotic patients with variceal etiology have more chances of rebleeding and have higher mortality than those with non variceal aetiologies. 

scholarly journals Endoscopic ultrasound guided emergency coil and glue for actively bleeding duodenal varix after failed endoscopy

2015 ◽  
Vol 6 (03) ◽  
pp. 139-141
Author(s):  
Narendra S. Choudhary ◽  
Rahul Rai ◽  
Puri Rajesh ◽  
Sud Randhir
Keyword(s):  
Endoscopic Ultrasound ◽  
Anatomical Location ◽  
Ultrasound Guided ◽  
Gastrointestinal Bleed ◽  
Duodenal Varix ◽  
Variceal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
Upper Gastrointestinal

AbstractManagement of ectopic variceal bleed may be difficult at times due to anatomical location or presence of collaterals. We present a case of an elderly cirrhotic male with acute upper gastrointestinal bleed due to a large duodenal varix successfully managed by endoscopic ultrasound guided coil placement along with glue (N-butyl-2-cyanoacrylate) injection.

Sign in / Sign up

Export Citation Format

Share Document