Vnitr Lek 2007, 53(12):1274-1277

The etiology of upper gastrointestinal bleeding in patients with liver cirrhosis

P. Svoboda^1,*, J. Ehrmann², P. Klvaňa¹, E. Machytka¹, M. Rydlo¹, V. Hrabovský¹

¹ Interní klinika FN Ostrava, přednosta doc. MUDr. Arnošt Martínek, CSc.

² II. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Vlastimil Procházka, Ph.D.

108 patients suffering from the cirrhosis of the liver and acute bleeding into the upper digestive tract underwent a prospective endoscopic examination with diagnostic and therapeutic objectives. The most frequent causes of acute bleeding included oesophagus varices (57.4 %) followed by peptic gastric ulcer (13.9 %) and peptic ulcer of duodenum (11.1 %), then portal hypertension gastropathy (5.6 %), gastric varices (4.6 %), reflux oesophagitis (2.8 %), Mallory-Weiss syndrom (2.8 %) and erosive gastropathy (0.9 %). The endoscopy of the upper digestive tract in one patient resulted in negative diagnosis. 69 % of examinations showed multiple findings in the upper digestive tract, each of which could have been a potential cause of bleeding. To determine the source of bleeding the specialist's attitude presented at the end of the endoscopic examination was taken into consideration. In 67.6 % of patients the bleeding was a direct consequence of portal hypertension, in 62 % it was caused by varices. The emphasis is put on early and thorough endoscopic examinations aimed at proper diagnosis and therapy.

Keywords: cirrhosis of the liver; portal hypertension; acute bleeding; peptic ulcer; endoscopy

Received: August 9, 2007; Accepted: September 3, 2007; Published: December 1, 2007  Show citation