Incidence and risk factors contributing for early variceal rebleeding after esophageal variceal ligation (EVL)
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 3
Abstract
Our aim is to assess incidence & risk factors contributing for early variceal rebleeding after esophageal variceal ligation (EVL). A prospective study was conducted on eighty patients with chronic liver diseases who underwent EVL. Follow up of patients for 2 weeks was done to evaluate the outcome then patients were divided into non-rebleeding group including 71 patients and early variceal rebleeding group including 9 patients. All patients were subjected to full history and clinical assessment, routine laboratory investigations, Child-Pugh classification, MELD score, abdominal ultrasonography, upper endoscopy to assess esophageal varices grade, number, extent, gastic varices, severity of portal hypertensive gastropathy and number of rubber bands used. Our results revealed incidence of early variceal rebleeding following EVL of 11%. Low serum albumin, high serum Creatinine, BUN, WBC and total bilirubin were risk factors contributing for early variceal rebleeding after EVL. Gastric varices, esophageal varices grade and extent are endoscopic risk factors contributing for early variceal rebleeding after EVL. The presence of ascites, history of multiple number of sessions of previous intervention, higher MELD score and Child-Pugh class C were statistically significant (p<0.05) in the rebleeding group compared to non rebleeding. Early variceal rebleeding following EVL was detected in 11% of our patients. Poor liver function as indicated by Child-Pugh and MELD scores with endoscopic findings of higher esophageal varices grade, number and extent of esophageal varices, Presence of gastric varices and number of session of previous intervention were risk factors contributing for early variceal rebleeding after EVL. Keywords: Esophageal varices, esophageal variceal ligation (EVL),Early variceal rebleeding.
Authors and Affiliations
Shendy Mohamed Shendy, Mohamed Darwish El-Talkawy, Abdel Aziz Ali Saleem, Hoda Abu Taleb, Mohamed Khairy Elnaggar
Keywords
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