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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-03
Incidence and risk factors contributing for early variceal rebleeding after esophageal variceal ligation (EVL)
Shendy Mohamed Shendy, Mohamed Khairy Elnaggar, Hossam Eldin Mohamed Salem
Published: May 30, 2015 |
136
108
DOI: 10.36347/sjams.2015.v03i03.105
Pages: 1553-1559
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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.