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Digestive Diseases and Sciences

, Volume 40, Issue 12, pp 2516–2521 | Cite as

A prospective study of upper gastrointestinal hemorrhage in patients with hepatocellular carcinoma

  • Winnie Yeo
  • J. Y. Sung
  • S. C. Ward
  • S. C. S. Chung
  • W. Y. Lee
  • A. K. C. Li
  • P. J. Johnson
Gastrointestinal Oncology

Abstract

Our purpose was to determine, in a prospective study, the causes of gastrointestinal hemorrhage in patients with hepatocellular carcinoma, and the relationship of portal vein invasion with variceal hemorrhage in these patients. During an 11-month period, 55 patients presented with hepatocellular carcinoma presented with signs and/or symptoms of upper gastrointestinal hemorrhage. Forty-seven percent had bleeding from varices, whereas the majority, 53%, had a nonvariceal bleeding source. Among those with nonvariceal bleeding, duodenal ulceration was the commonest cause. Direct tumor invasion into the gastrointestinal tract was found in three patients. Tumor invasion of the portal venous system was detected by ultrasound examination in 76% of the variceal bleeders, compared to only 45% of the nonvariceal bleeders. Despite the very high frequency of cirrhosis among patients with hepatocellular carcinoma, the source of bleeding was variceal in less than half of the patients. Portal vein invasion is a risk factor for subsequent variceal bleed.

Key Words

gastrointestinal hemorrhage hepatocellular carcinoma portal vein thrombosis 

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Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Winnie Yeo
    • 1
    • 2
    • 3
    • 4
  • J. Y. Sung
    • 1
    • 2
    • 3
    • 4
  • S. C. Ward
    • 1
    • 2
    • 3
    • 4
  • S. C. S. Chung
    • 1
    • 2
    • 3
    • 4
  • W. Y. Lee
    • 1
    • 2
    • 3
    • 4
  • A. K. C. Li
    • 1
    • 2
    • 3
    • 4
  • P. J. Johnson
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of Clinical OncologyChinese University of Hong Kong, Prince of Wales HospitalShatin, NTHong Kong
  2. 2.Department of MedicineChinese University of Hong Kong, Prince of Wales HospitalShatin, NTHong Kong
  3. 3.Department of SurgeryChinese University of Hong Kong, Prince of Wales HospitalShatin, NTHong Kong
  4. 4.Department of Diagnostic Radiology & Organ ImagingChinese University of Hong Kong, Prince of Wales HospitalShatin, NTHong Kong

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