الفهرس 
AcknowledgementsOnly 14 pages are availabe for public view
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Abstract
Summary & conclusions
Our study included 500 Patients with liver cirrhosis and portal hypertension underwent oesophago-gastro-duodenoscopy after upper GIT bleeding at the Tropical Medicine and Gastroenterology Department, Sohag University Hospital. All patients subjected to complete history taking, clinical examination, laboratory investigations, abdominal ultrasound & EGD.
Our results showed that bleeding from gastric varices was seen in 50 patients (10 %), bleeding from esophageal varices was detected in 400 patients (80 %), while bleeding from other sources (non variceal bleeding) was in 50 patients (10%). Among the 50 cases of bleeding gastric varices, we found the most common etiology for the liver cirrhosis & portal hypertension was HCV which was detected in 40 patients (80%), while HBV was detected in 2 patients only (4%).
According to ultrasonograpgic findings, the whole studied population had signs suggestive of liver cirrhosis , diameter of portal vein was dialted in 38 patients (76%) & thrombosed in 9 patients (18%), Only 5 patients (10%) had HFLs , Splenomegaly was a common finding as it was detected in 45 patients (90%) but ascites was present in 17 patients (34%) .
After Primary hemostasis had achieved in all patients with histoacryl injection, moderately sized varices (F2) were found in 74% of the patients, only 70% of the patients had isolated GV type I & 30% had continuous Gastroesophogeal varices type 2 with red colour signs (Rc+) in 80% of the cases.
Bleeding was more common between Child A patients but there were no significant differences as regard child classification or size of varices. There were no definite risk factors for bleeding GV as our study didn’t have control group to identify them by comparison with the study group.
Regarding the outcome, 40% had eradicated gastric varices, 38% died & 22% developed re-bleeding. No dependent factors could predict the mortality; also there was no relation between rebleeding and Child class, endoscopic signs, size of isolated gastric varices and any of ultra-sonographic findings & by multivariate analysis we found that were no independent predictors of rebleeding gastric varices.