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Upper Gastrointestinal Bleeding 

Upper Gastrointestinal Bleeding
Chapter:
Upper Gastrointestinal Bleeding
Author(s):

S Chandra

, Su Min Cho

, and Ali Al-Khafaji

DOI:
10.1093/med/9780199768899.003.0003
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date: 20 February 2020

Upper gastrointestinal bleeding (UGIB) is a major cause of morbidity and mortality in patients with end-stage liver disease (ESLD) and in majority of the cases is a direct consequence of portal hypertension (PH). Despite improvements in therapeutic options and supportive therapy, the 6-week mortality rate remains high: from 15% to 30% in patients with Child class C. The annual incidence of UGIB in patients with cirrhosis and PH is approximately 25% to 35% per year.

Esophageal and gastric variceal bleeding accounts for the majority of episodes of UGIB in patients with cirrhosis. In a study of 465 patients with cirrhosis, the etiology for UGIB was esophageal varices (64%), gastric varices (8.4%), portal hypertensive gastropathy (9.5%), and peptic ulcer disease (7.5%), with esophagitis, erosions, and esophageal ulcers accounting for the rest.

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