Acute Variceal Bleeding in Patients with Liver Cirrhosis with and without Diabetes

Khafaga S, Khalil K, Mohamed Abdou, Miada M, Mahmoud Shedid and Mohammad Mosaad*

Acute Variceal Bleeding in Patients with Liver Cirrhosis with and without Diabetes

Variceal bleeding is one of the major complications of portal hypertension;
Gastroesophageal varices are present in 40-60% of patients with cirrhosis
and their rupture constitutes the most common lethal cause of mortality in those patients.

However, it has decreased from 47% to 13% with the use of pharmacological,
endoscopic, and radiological intervention. The presence of esophageal varices
correlates with the severity of liver disease as it is found
in about 40% of Child A, and 85% of Child C patients.

Various factors have been proposed as predictors of outcome
of variceal bleed such as age of the patient, gender,
stage of cirrhosis, etiology of the disease, associated
conditions like renal failure, Hepatocellular carcinoma
(HCC), and Diabetes Mellitus (DM) which is frequently
associated with cirrhosis.

Regardless the cause for diabetes, hyperglycemia induces splanchnic
hyperemia, increases portal pressure
and may increase the risk of variceal bleeding.

Adult patients aged ≥18 years, both sexes, with liver
cirrhosis and variceal bleeding with or without DM, patient′s
gave written informed consent and including the adherence

During the hospital stay all patients were formally
clerked with complete history taking, clinical assessment;
laboratory investigations including Complete Blood Count,
Liver function tests, renal function tests,
fasting blood sugar, and 2 h post-prandial; also abdominal
Ultrasound (US) were done for all the patients.

Gastric varices were classified as described by Sarin and Kumar in 1989;
the source of bleeding.

Liver Res Open J. 2015; 1(1): 14-20. doi: 10.17140/LROJ-1-103