Year-end Sale % OFF 
Abstract
Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices. This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017. Consecutive cases who presented in emergency room with acute variceal bleeding due to liver cirrhosis and cases of liver cirrhosis with large varices and red color signs on endoscopic examination were enrolled. They underwent EVL and subsequent re-endoscope at one month interval till the eradication of varices was achieved. Among 83 patients, 15 (18.1%) were of Child Pugh class A, 29 (34.9%) B and 39 (47%) were of C. In 20 (24.1%) cases varices could be eradicated in one session of EVL while 57 (68.7%) required two sessions and in 6 (7.2%) cases it took three sessions. Total average EVL session required for obliteration of esophageal varices was 1.84±0.53. There was only one (1.2%) of early re-bleeding post EVL. EVL is an effective modality of treatment in controlling acute esophageal variceal bleeding, in preventing future variceal bleeding as well as in eradicating esophageal varices with very few complications.
Highlights
Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality
This study was done to see the outcome of esophageal variceal ligation (EVL) in controlling acute esophageal variceal bleeding, outcome of prophylactic banding of large varices with red color signs and the number of sessions required for complete eradication of varices
Consecutive cases of acute variceal bleeding who presented in emergency room of Bir hospital with acute variceal bleeding due to cirrhosis and admitted in the Gastroenterology and Hepatology Unit, cases of varices with history of bleeding in recent past and patients with large varices with red color signs found during evaluation of cirrhotic patient were enrolled in this study
Summary
Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. Bleeding from varices in liver cirrhosis (LC) and portal hypertension is the leading cause of death.[1] It is an emergent condition with high mortality.[2,3,4] The prevalence of esophageal varices in LC is around 80%90%5,6 and variceal hemorrhage occurs at a rate of 10%-30% yearly.[7] Two studies from Nepal have shown esophageal varices as the cause of upper GI bleeding in 47.5%8 and 15.6%9 cases respectively. Despite early management of variceal hemorrhage, the mortality remains 20%-35%.10-12. The 6-week mortality with each episode of variceal hemorrhage is 15-20%, ranging from 0% among Child Pugh class A to 30% Despite early management of variceal hemorrhage, the mortality remains 20%-35%.10-12 The 6-week mortality with each episode of variceal hemorrhage is 15-20%, ranging from 0% among Child Pugh class A to 30%
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
