Frequency of gastro oesophageal varices in liver cirrhosis

Background: Gastroesophageal varies can present as one of the complication of liver cirrhosis

Objective: To determine the frequency of gastro oesophagealvarices in liver cirrhosis

Methodology: This was a cross sectional study, carried out at Department of Medicine, Sheikh Zayed Hospital, Rahim Yar Khan from 1st July to 31st December 2016. The cases of liver cirrhosis diagnosed on clinical suspicion and radiological findings of coarse echo texture of liver, dilated portal vein more than 1cm with or without ascites falling in child pugh class B and C were included. The cases were included of both gender with age range of 20-70 years. These cases then underwent upper GI endoscopy at same institute and were looked for gastro oesophageal varices. Data analysis was done by using SPSS version 20

Results: In this study, there were total 100 cases, out of which 64 [64%] were males and 36 [36%] were females. The mean age was 53+/-11 years. Gastric varices were seen in 14 [14%] of the cases. Gastric varices were significantly high in cases with child pugh class C where it was seen in 12 [17.14%] of cases with p= 0.04. This was also significantly high in cases that had duration of liver cirrhosis more than 5 years where it was seen in 13 [20.96%] of cases with p value of 0.001

Conclusion: Gastro oesophageal varices are not uncommon in cases of liver cirrhosis and it is significantly high in cases with duration of cirrhosis more than 5 years and child pugh class C

Efficacy of terlipressin in upper gi bleeding due to liver cirrhosis

Background: Upper Gastrointestinal bleeding [GI] bleeding can be a fatal and life threatening emergency and need emergency treatment to avoid unwanted morbidity and mortality

Objective: To determine the efficacy of Terlipressin in cases of upper GI bleeding due to liver cirrhosis

Methodology: In this case series, there were total 50 cases of upper GI bleed within last 24 hours due to liver cirrhosis of both genders, falling in the age range of 30-70 years, presenting to medical wards and emergency department. Terlipressin was injected in a dose of 1mg every 6 hour. This therapy was given for maximum of 72 hours. The efficacy was labeled as yes when there was no bleeding episode over 12 hours. Data was entered and analyzed by sing SPSS version 21

Results: In this study, there were total 50 cases out of which 35 [70%] were males and 15 [30%] females. The mean age and duration of cirrhosis were 49.45+/-6.85 years and 4.87+/-2 years respectively. The efficacy was almost equal in both genders [p= 0.95]. The efficacy was slight better in age group 30-49 years where 16 [69.56%] out of 23 cases had it [p= 0.12]. The efficacy was significantly better in Class A where 4 [80%] out of 5 cases had it as compared to Class B and C with p= 0.01

Conclusion: Terlipressin has good efficacy in treating upper GI bleed in cases with liver cirrhosis and this is significantly better in cases with Child Pugh Class A