Variceal bleeding revisited: A clinicoepidemiological study | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2001]

Author(s):

1. Kamran Khalid: King Saud University, Riyadh Medical Complex, Riyadh, Saudi Arabia.

2. Saleh Al-Salamah: College of Medicine & KKUH, University Unit, King Saud University, Riyadh Medical Complex, Riyadh, Saudi Arabia.

Abstract:

To suggest the preventive strategies for vericeal bleeding, a potentially fatal complication of portal hypertension and a commonest cause of acute upper gastrointestinal (GI) hemorrhage in Saudi Arabia, by reviewing the etiology, presentation and outcome of bleeding varices. Design: Retrospective and prospective analysis of medical records of all the patients with first episode of gastrointestinal bleeding. Place and Duration: Two and a half years period extending from November 15,1998 through May 14, 2001 in the Gastro Intestinal Bleeding Unit (GIBU) of Riyadh Medical Complex, Saudi Arabia. Patients and Methods: Patients presenting with hematemesis and/or malena due to bleeding portal hypertension were included in the study. A detailed history and examination was followed by relevant laboratory, serology and imaging investigations. The patients were subsequently categorized employing Child-Pugh scoring system. Overall mortality due to massive uncontrolled bleeding and the operations for bleeding varices were recorded. Results: Bleeding varices were the commonest cause of acute upper GI bleeding (38.23%). Mean age was 48.3 years with male preponderance (4.4:1). Thirty-seven out of 44 (84%) patients with previous blood transfusion or donation became seropositive for hepatitis. Hepatitis was the commonest etiology (53.3%). Alcoholic cirrhosis was observed in 4.24% patients. Most of the cases (53.3%) were in Child class B. Injection sclerotherapy was successful in 87.74% cases. The overall in-hospital mortality was 12.26%. Conclusion: Variceal bleeding remained the commonest cause of acute upper GI hemorrhage in central Saudi Arabia. Hepatitis C was found to be the most common cause of chronic liver disease. Alcohol consumption should be considered in the etiology. Increased public awareness about hepatitis as well as hazards of alcohol abuse along with strict hepatitis screening of blood can be regarded as important preventive measures

Page(s): 754-758

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 11, Issue: 12, Year: 2001

Keywords:

Hypertension , Portal Hepatitis Varicose Veins Gastrointestinal Hemorrhage

References:

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