الفهرس 
CHRONIC LIVER DISEASEOnly 14 pages are availabe for public view
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Abstract
C
irrhotic patients are immunocompromised with high risk of infection. Diagnostic upper GIT endoscopy, injection sclerotherapy and band ligation of esophageal varices may contribute to bacterial infections due to disruption of natural barriers.
This study is designed to compare between bacteremia following injection sclerotherapy and band ligation of esophageal varices, also to determine the most causative organisms and their antibiotic sensitivity
The present study was performed on 90 patients admitted to Ain Shams Hospital. The enrolled 90 patients had various stages of chronic liver disease.
According to endoscopic procedure patients were divided into three groups:
group 1:30 patients who underwent diagnostic upper GIT endoscopy (control group).
group 2:30 patients who underwent band ligation of ov.
Group3:30 patients who underwent injection sclerotherapy of ov.
Full history and clinical examination was done to all patients before the endoscopic procedure. All 90 patients were subjected to full laboratory tests, abdominal ultrasound.
Blood culture before and 30 minutes after the endoscpic procedure was done to all patients.
Regarding incidence of bacteremia: group (1) and (2) showed no bacterial growth with (0%) bacteremia after diagnostic endoscopy and band ligation.
group (3) revealed 2 patients with positive bacteremia after sclerotherapy (6.67%). Isolated bacteria were (strept viridians) in one case (3.33%) and hemolytic strept) in the other case (3.33%).
Comparison of incidence of bacteremia between the three groups revealed no significant difference in incidence of bacteremia.
Both cases of bacteremia were Chid C. Comparison between incidence of bacteremia and Chid classification in group (3) revealed bacteremia incidence in Chid C was (28.6%) with significant difference between different Child classes in group (3).
Antibiotic sensitivity to both types of bacteremia revealed common sensitivity to (amox. fluclox, amp. salbact, amox. clav, vancomycin, sulperazon).
No specific sensitivity of strept viridians bacteria but there specific sensitivity of hemolytic strept to (Impeniem, cefotaxime) antibiotics.