Peptic ulcer in cirrhosis: an endoscopic study

Background: Liver cirrhosis results in portal hypertension, splenomegaly, esophageal varices and peptic ulcers. Fatal hemorrhage in patients of cirrhosis due to mainly variceal haemorrhage and some extend to peptic ulcers. Peptic ulcer bleeding is a serious complication with significant morbidity and mortality.

Objective: To determine the frequency of peptic ulcers and pattern of peptic ulcer among patients of liver cirrhosis.

Methods: This is a hospital based observational study carried out in the Department of Hepatology, Shaheed Ziaur Rahman Medical College Hospital (SZMCH),Bogra over a period of 06 months, from January 2018 to June 2018. The study was approved by the Ethical Institutional Review Board (IRB) of SZMC, Bogura. Sixty three index patients of liver cirrhosis were enrolled in the study after the exclusion criteria. These patients were then subjected to upper gastrointestinal endoscopy after informed consent and the presence and pattern of peptic ulcers were noticed.

Results: Among 63, 73% were male (n=46) and mean age was 50.92 (±12.13) years with range from 22 to 78. Mean Child-Pugh score was 8.90 ± 2.22. Most common cause (49.3%) of liver cirrhosis was chronic hepatitis B.  Peptic ulcers were present 41.3 % (26) among them GUD and DUD were 22.2% (14) and 14.3 % (09) respectively. Peptic ulcer was predominant in Child-Pugh C group 69.2 % (18).

Conclusions: Peptic ulcer is common in liver cirrhosis and more especially in Child Pugh C. liver cirrhosis patient should be screened for the presence of peptic ulcer at the time of initial diagnosis, and at periodic intervals thereafter throughout life.


Abu Saleh Mohammad Sadequl Islam

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