ANALYSIS OF RE-BLEEDING AFTER ENDOSCOPIC MANAGEMENT OF ESOPHAGEAL VARICES IN CIRRHOTIC PATIENTS

Introduction: Portal hypertension (PH), defined as hepatic venous pressure gradient of more than 5 mmHg, is one of the major complications of the liver cirrhosis. Clinical complications of portal hypertension, including gastroesophageal varices, become evident once hepatic venous pressure gradient gradient exceeds 10 mmHg. Aims and objectives: The basic objective of the study was to analyze the frequency of re-bleeding after successful endoscopic management of esophageal varices in cirrhotic patients. methodology of the study: This study was conducted at RHC Ganda Singh Wala, Kasur during 2018. There are 80 patients who were selected for this study. Both males and females were included who have evidence of cirrhosis on the basis of clinical history, examination, biochemical and radiological investigations, had first episode of upper gastrointestinal bleeding secondary to esophageal varices and had undergone band ligation. Results 80 cases with history of cirrhosis and previous band ligation were chosen for the study. Out of which 49 (61.3%) were male and 31 (38.8) were of female gender. Causes of liver cirrhosis were identified as 63(78.8%), 5(6.3%) and 12(15%) for hepatitis C. hepatitis B and Non B. Non C respectively. Conclusion: It is concluded that EVBL is found to be an effective modality in reducing the frequency of rebleeding in cirrhotic patients. Severity of liver disease and number of variceal columns were independent risk contributing to re-bleeding.