Clinical Analysis of Non-variceal Upper Gastrointestinal Bleeding in Cirrhotic Patients

【Objective】 To investigate the clinical characters of non-variceal upper gastrointestinal bleeding in cirrhotic patients through retrospective analysis.【Methods】 All consecutive adult patients with upper gastrointestinal bleeding(UGIB)(age ≥ 18 years) admitted from June 2011 to July 2012 were prospectively registered.During a 12-month period,a retrospective populationbased study including all the UGIB of 464 people was conducted.Sixty cases(12.9%) with non-variceal upper gastrointestinal bleeding in cirrhotic patients were included.Compared with 158 cases with variceal upper gastrointestinal bleeding in cirrhotic patients,there were significant differences in epidemiologic features,clinical course and clinical outcomes.Endoscopic findings of non-esophageal variceal bleeding(NEVB) are different between cirrhotic patients and non-cirrhotic patients.【Results】 The noncirrhotic patients with NEVB accounted for the ratio of non-cirrhotic patients with upper gastrointestinal hemorrhage was 27.5% in the same period.Variceal bleeding in cirrhosis accounted for the ratio of upper gastrointestinal bleeding with cirrhosis was 72.5%.The cirrhotic patients with NEVB over the same period accounted for the ratio of gastrointestinal bleeding was 12.9%.Clinical manifestations of non-variceal upper gastrointestinal bleeding with cirrhosis are vomiting coffee-like compounds based.Hematemesis is the most frequent clinical manifestation of variceal upper gastrointestinal bleeding in cirrhotic patients.Our results show that cirrhotic patients with NEVB may develop hypertension more often than non-cirrhotic patients.However,gastric and esophageal ulcers as a source of NEVB are more frequent in cirrhotic patients.【Conclusions】 Cirrhotic patients with non-variceal bleeding is not uncommon for the highest incidence of duodenal ulcer.Cirrhotic patients are more susceptible to be gastric ulcer and esophageal ulcers.Prompt endoscopy is essential for the treatment decision.