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

Abstract

Objectives: To study the effect of diabetes mellitus on presentations, course, and outcome of acute variceal bleeding in cirrhotic patients. Methods: We compared 2 matched groups of patients, a diabetic group and non-diabetic group, where all of the patients presented with acute esophageal varices due to liver cirrhosis. All pa- tients underwent history taking, clinical examination, emergency treatment, upper endoscopy, laboratory investigations and abdominal ultrasound; they followed up until hospital discharge. Results: The diabetic group showed statistically significant unstable course in 73.3% of them compared to 36.6% in the control; more attacks of melena (2.2±1.03) compared to control (1.7±0.88), and also had significantly disturbed level of consciousness compared to control (36.7% versus 10% respectively); moreover they have significantly more right and left lobe enlargement than control (70% versus 26.7%, and 66.7 versus 40% respectively), significantly more echogenic liver (70% versus 33.3), highly significant more portal vein dilatations (73.3% versus 16.7%) and highly significant more collaterals (50% versus 23.3%); the splenic size was also significantly more enlarged in diabetics (60%) than control (40%), and the splenic vein di - ameter was significantly more dilated in diabetics (33.3%) versus control group (6.7%); finally the mortality was more in the diabetic group. Conclusions: Diabetic patients with acute variceal bleeding may show more morbidity and mortality rates.