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• W4296475314 abstract "<h3>Background</h3> Acute upper gastrointestinal bleeding in patients with cirrhosis is associated with a high complication and mortality rate. Many patients require management in the intensive care unit due to multi-organ dysfunction. Urgent treatment should be started when bleeding is suspected. This includes correction of hypovolaemia, blood product administration alongside vasopressor therapy (commonly Terlipressin). Antibiotic prophylaxis is recommended due to infection risk and has prognostic benefit. Early upper gastrointestinal endoscopy with endotherapy is recommended. <h3>Methods</h3> We reviewed medical records of patients with chronic liver disease who presented with gastrointestinal bleeding to our hospitals over an 8 month period. Baseline data was tabulated including gender, age and aetiology of liver disease. Patients were identified by reviewing medical admission records and were cross referenced with electronic prescriptions of Terlipressin. Presenting symptoms, endoscopic findings and location of endoscopy (emergency theatres or Endoscopy unit) were recorded. Antibiotic and Terlipressin prescriptions were reviewed. <h3>Results</h3> 50 admissions were identified. Mean age was 48 years old (Range 34–84 years). 28 patients (55%) were male, 22 patients were female. 34 patients had an established diagnosis of chronic liver disease prior to admission. 29 (83%) had Alcohol related liver disease. Other aetiologies included metabolic associated liver disease (4 patients) and non- cirrhotic portal hypertension (2 patients). 25 patients had confirmed variceal bleeding at endoscopy. 20 of these required endoscopic therapy (18, oesophageal variceal band ligation, 2 gastric varix glue injection). All patients were treated with Terlipressin and 24 received antibiotic prophylaxis according to trust guidelines. 28 patients were considered to have a non variceal cause of bleeding at the time of endoscopy; however 19 (73%) also had endoscopic evidence of portal hypertension. Other causes of bleeding included a gastric ulcer (5 patients), duodenal ulcer (5 patients), oesophagitis (4 patients) and Mallory Weiss tear (1 patient). 7 patients died during the admission with gastrointestinal bleeding, 5 died later that year during a subsequent admission. <h3>Conclusion</h3> Variceal and non variceal bleeding is common in patients with chronic liver disease, and in our hospitals, the majority of patients admitted had a prior diagnosis of alcohol related liver disease. These patients were young, with a high risk of morbidity and mortality. In our experience, the majority of patients with suspected or known liver disease admitted with gastrointestinal bleeding are treated with Terlipressin and antibiotic prophylaxis. We have developed a local guideline for managing acute gastrointestinal bleeding in patients with chronic liver disease." @default.
• W4296475314 created "2022-09-21" @default.
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• W4296475314 date "2022-09-01" @default.
• W4296475314 modified "2023-09-27" @default.
• W4296475314 title "OP24 Upper gastrointestinal bleeding in patients with chronic liver disease; a district general hospital experience" @default.
• W4296475314 doi "https://doi.org/10.1136/gutjnl-2022-basl.37" @default.
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