Abstract
A 64-year-old woman was admitted to the gastroenterology department with hematemesis and melena which she had had for 24 h. She had a previous history of alcoholic liver cirrhosis complicated by esophageal varices. Physical examination on admission revealed mild jaundice, hepato-splenomegaly and ascites. The laboratory tests showed signs of hypersplenism (thrombopenia, leukopenia), abnormal serum liver tests, elevated serum bilirubin levels, low serum albumin levels, a prolonged prothrombin time (INR 1.79) and elevated urea levels (112 mg/dl). An emergency endoscopic examination of the upper gastro-intestinal tract disclosed esophageal varices.
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