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Non-variceal upper gastrointestinal bleeding in cirrhotic patients in Nile Delta
Mamdouh Ahmed Gabr1, Mohamed Abd El-Raouf Tawfik2, Abd Allah Ahmed El-Sawy1
1Hepatogastroenterology and Endoscopy Unit, Internal Medicine Department, Tanta University Hospital, Tanta, Egypt.
Insights
In cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB), non-variceal sources accounted for 24.5% of cases. Peptic ulcers were the most frequent non-variceal cause in this population.
Area of Science:
- Gastroenterology
- Hepatology
- Internal Medicine
Background:
- Acute upper gastrointestinal bleeding (AUGIB) in cirrhotic patients often stems from esophageal and gastric varices.
- However, non-variceal sources also contribute significantly to bleeding in this demographic.
Purpose of the Study:
- To determine the prevalence of non-variceal upper gastrointestinal bleeding (UGIB) in cirrhotic patients with portal hypertension.
- To identify the specific causes of non-variceal UGIB in this patient group within the Nile Delta region.
Main Methods:
- Emergency upper gastrointestinal (UGI) endoscopy was performed on 650 patients presenting with AUGIB.
- A cohort of 550 patients with confirmed cirrhosis was selected for this study.
Main Results:
- Variceal bleeding (esophageal and gastric) was observed in 75.5% of cirrhotic patients.
- Non-variceal bleeding sources were identified in 24.5% of the study population.
- Peptic ulcer disease was the predominant cause of non-variceal bleeding.
Conclusions:
- Non-variceal bleeding is a notable, though less frequent, cause of AUGIB in cirrhotic patients.
- Key non-variceal sources include peptic ulcers, portal hypertensive gastropathy, and erosive conditions of the stomach and duodenum.
Background And Study Aims:
Acute upper gastrointestinal bleeding (AUGIB) in cirrhotic patients occurs mainly from esophageal and gastric varices; however, quite a large number of cirrhotic patients bleed from other sources as well. The aim of the present work is to determine the prevalence of non-variceal UGIB as well as its different causes among the cirrhotic portal hypertensive patients in Nile Delta.
Methods:
Emergency upper gastrointestinal (UGI) endoscopy for AUGIB was done in 650 patients. Out of these patients, 550 (84.6%) patients who were proved to have cirrhosis were the subject of the present study.
Results:
From all cirrhotic portal hypertensive patients, 415 (75.5%) bled from variceal sources (esophageal and gastric) while 135 (24.5%) of them bled from non-variceal sources. Among variceal sources of bleeding, esophageal varices were much more common than gastric varices. Peptic ulcer was the most common non-variceal source of bleeding.
Conclusions:
Non-variceal bleeding in cirrhosis was not frequent, and sources included peptic ulcer, portal hypertensive gastropathy, and erosive disease of the stomach and duodenum.
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