Upper gastrointestinal haemorrhage in hepatic cirrhosis: causes and relation to hepatic failure and stress.Lancet. 1977 Jan 29; 1(8005):218-20.Lct
Emergency fibroscopy revealed bleeding lesions in 84 cirrhotic patients. In patients with moderate or no hepatic failure, the commonest actively bleeding sources were oesophagogastric varices and acute mucosal ulcers associated with the ingestion of anti-inflammatory drugs. In patients with severe hepatic failure, acute mucosal ulcers unrelated to drugs predominated and there was evidence that these were stress-induced erosions.