CHARACTERISTICS OF UPPER GASTROINTESTINAL BLEEDING IN CIRRHOTIC PATIENTS

Aims:

The aim of our study is to specify the characteristics of upper gastrointestinal bleeding in cirrhotic patients.

Methods:

This is a retrospective (from March 2015 to November 2015) and a prospective (December 2015 to March 2017) descriptive and analytical study of service of the gastroenterology of our hospital, during a period of 22 months, Ont All cirrhotic patients with high gastrointestinal bleeding (n = 44) were included. Epidemiological, clinical, endoscopic, therapeutic and evolutionary data were treated

Results:

The mean age was 37 years with a male predominance (sex ratio H/F = 1.3). The etiology of cirrhosis was post viral in 36.3%, indeterminate in 61.3%, and primary biliary cirrhosis in 2.27% of cases. A history of hemorrhagic decompensation was found in 45.4% cases, 56.8% patients were under beta-blocker, upper gastrointestinal hemorrhage revealed by hematemesis, melena in 59.09% cases, isolated hematemesis in 29.5% patients, isolated melena in 11.3% cases. The etiology of HDH was the rupture of oesophageal varices in 84.09% of the cases, classified stage III in 32.4%, the ulcer hemorrhagic in 13.6% of the cases, the rupture of the varices under cardiac in 4.5% of the cases, with like lesions Associated with gastritis in 13.6% of cases, and oesophagitis in 9.09% cases. The use of transfusion was necessary in 34.09% of cases. Hemorrhagic recurrence was noted in 4.5% cases, with a mortality rate of 6.8%, higher than the non-cirrhotic patient P = 0.06.

Conclusions:

The main etiology of upper gastrointestinal bleeding in cirrhotic patients is the rupture of esophageal varices, although a significant rate of ulcer disease was noted (13.6%). This population as the mortality rate was higher compared to non-cirrhotic patients