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[Upper digestive hemorrhage in liver cirrhosis: clinical and endoscopic findings].
Acta Gastroenterol Latinoam. 1992; 22(3):181-6.AG

Abstract

There are different opinions in respect to the main sources in upper gastrointestinal bleeding in hepatic cirrhosis. Some authors claim that ruptured esophageal varices are the cause of most of the hemorrhages. Recently, characteristic lesions have been showed in the gastric mucosa in portal hypertension (congestive gastropathy), and many believe that they are frequently the origin of the bleeding. We reviewed the records of 195 episodes of upper gastrointestinal bleeding in cirrhosis, with endoscopy performed within 12 hours of entry, and report here the endoscopic findings and the bleeding sites. We also investigated the relation between the etiology and functional class of the hepatic disease and the bleeding source. We observed variceal hemorrhage in 52.2% of cases; by gastroduodenal mucosal lesions in 13.8%; by gastric and duodenal ulcers in 13.8%; undetermined origin in 14.8% (due to coexistence of two or more lesions, without active bleeding). We found no differences between alcoholic and nonalcoholic cirrhotics in the bleeding sources. Furthermore, the bleeding sites were not different either in child A, B and C patients. In contrast, in major hemorrhages, esophageal varices were more frequently the origin (73.5%) than in minor ones (40.4%) (p < 0.002). The mortality was significantly higher in CHild C group (25%), than in groups B (14.3%) and A (2.3%) (p < 0.05 and p < 0.002, respectively). We recommend to carry out early endoscopy in every cirrhotic patient suffering from gastrointestinal bleeding, by skilled performers who are able to recognize the gastric red signs, before making a decision about potentially dangerous therapeutic measures, such as surgery, balloon tamponade, etc.

Authors+Show Affiliations

Fassio E
Servicio de Gastroenterología, Hospital Nacional Profesor A. Posadas, Haedo, Buenos Aires, Argentina.
Viudez P
No affiliation info available
Landeira G
No affiliation info available
Fernández N
No affiliation info available
Lattanzi M
No affiliation info available
Luis A
No affiliation info available

MeSH

AdolescentAdultAgedArgentinaChi-Square DistributionChildEndoscopy, Digestive SystemEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHumansLiver CirrhosisLiver Cirrhosis, AlcoholicMaleMiddle AgedPeptic UlcerPeptic Ulcer HemorrhageTime Factors

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

spa

PubMed ID

1341118

Citation

Fassio, E, et al. "[Upper Digestive Hemorrhage in Liver Cirrhosis: Clinical and Endoscopic Findings]." Acta Gastroenterologica Latinoamericana, vol. 22, no. 3, 1992, pp. 181-6.
Fassio E, Viudez P, Landeira G, et al. [Upper digestive hemorrhage in liver cirrhosis: clinical and endoscopic findings]. Acta Gastroenterol Latinoam. 1992;22(3):181-6.
Fassio, E., Viudez, P., Landeira, G., Fernández, N., Lattanzi, M., & Luis, A. (1992). [Upper digestive hemorrhage in liver cirrhosis: clinical and endoscopic findings]. Acta Gastroenterologica Latinoamericana, 22(3), 181-6.
Fassio E, et al. [Upper Digestive Hemorrhage in Liver Cirrhosis: Clinical and Endoscopic Findings]. Acta Gastroenterol Latinoam. 1992;22(3):181-6. PubMed PMID: 1341118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Upper digestive hemorrhage in liver cirrhosis: clinical and endoscopic findings]. AU - Fassio,E, AU - Viudez,P, AU - Landeira,G, AU - Fernández,N, AU - Lattanzi,M, AU - Luis,A, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 181 EP - 6 JF - Acta gastroenterologica Latinoamericana JO - Acta Gastroenterol Latinoam VL - 22 IS - 3 N2 - There are different opinions in respect to the main sources in upper gastrointestinal bleeding in hepatic cirrhosis. Some authors claim that ruptured esophageal varices are the cause of most of the hemorrhages. Recently, characteristic lesions have been showed in the gastric mucosa in portal hypertension (congestive gastropathy), and many believe that they are frequently the origin of the bleeding. We reviewed the records of 195 episodes of upper gastrointestinal bleeding in cirrhosis, with endoscopy performed within 12 hours of entry, and report here the endoscopic findings and the bleeding sites. We also investigated the relation between the etiology and functional class of the hepatic disease and the bleeding source. We observed variceal hemorrhage in 52.2% of cases; by gastroduodenal mucosal lesions in 13.8%; by gastric and duodenal ulcers in 13.8%; undetermined origin in 14.8% (due to coexistence of two or more lesions, without active bleeding). We found no differences between alcoholic and nonalcoholic cirrhotics in the bleeding sources. Furthermore, the bleeding sites were not different either in child A, B and C patients. In contrast, in major hemorrhages, esophageal varices were more frequently the origin (73.5%) than in minor ones (40.4%) (p < 0.002). The mortality was significantly higher in CHild C group (25%), than in groups B (14.3%) and A (2.3%) (p < 0.05 and p < 0.002, respectively). We recommend to carry out early endoscopy in every cirrhotic patient suffering from gastrointestinal bleeding, by skilled performers who are able to recognize the gastric red signs, before making a decision about potentially dangerous therapeutic measures, such as surgery, balloon tamponade, etc. SN - 0300-9033 UR - https://www.unboundmedicine.com/medline/citation/1341118/[Upper_digestive_hemorrhage_in_liver_cirrhosis:_clinical_and_endoscopic_findings]_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -