History Of Esophageal Bleeding Research Articles

Risk Factors of Esophageal Bleeding in Children with Various Etiologies of Liver Cirrhosis – A Single-Center Report from Iran

Abstract Esophageal bleeding is a common complication in patients with liver cirrhosis. In thee present study, our aim was to divulge major factors predicting esophageal bleeding in Iranian children with liver cirrhosis. This was a cross-sectional study including 101 children < 18 years old referred to the Pediatric Endoscopy Unit of Nemazee Teaching Hospital of Shiraz from 2014 until 2016. Children with esophageal varices were included. The patients were divided into two groups including those with and without history of esophageal bleeding. Statistical methods were performed in SPSS 16 software. There were 49 boys and 52 girls. The mean age was 7.74±5.26 years old. A history of esophageal bleeding was observed in 53 (52.4%). In univariate analyses, significant relationships were found between esophageal bleeding and varices size (P=0.001), Child-Pugh score (P=0.01), age of bleeding initiation (P<0.001), serum creatinine (P=0.01), and serum sodium (P=0.002). There was no statistically significant difference in the mean of PELD/MELD score among children with (12.34±12) and without (14.61±17.51) history of esophageal bleeding (P=0.5). Among various etiologies of cirrhosis, a significant association was observed between autoimmune hepatitis and the history of esophageal bleeding (P=0.01). Regarding the clinical importance of esophageal bleedings in children with liver cirrhosis, it is recommended to further divulge the risk factors pre-disposing to this event.

Carcinoma of Esophagus Perforating the Aorta

Perforation of a carcinomatous ulcer of the esophagus is not uncommon. Kaufman found that it occurred in 45 per cent of his cases. The perforation may take place into the trachea and bronchi, the mediastinum, large blood vessels and pleural or pericardial cavities. Erosion of large blood vessels with fatal hemorrhage, is, however, quite rare. Kaufman noted erosion into the aorta four times in 126 cases of carcinoma of the esophagus. Knaut collected all reported cases up to 1896 which numbered 50, and since Knaut's study Carr and Hanford in 1922 found 21 cases in the literature and added one of their own. Since 1922 occasional cases have been added to the literature. We have recently had a case of esophageal carcinoma which perforated into the aorta and caused fatal hemorrhage and because of the rarity of this condition and the long history of esophageal bleeding we believe this case is of sufficient interest to warrant reporting.