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Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively

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Abstract

Upper gastrointestinal hemorrhage is one of the more important complications of cirrhosis and a major cause of death in such patients. The main sites of bleeding are esophageal varices, gastritis, and peptic ulcers. In order to determine the prevalence of either potential bleeding lesions or of other endoscopic findings in hemodynamically stable individuals with various etiologies of cirrhosis, 510 consecutive cirrhotic patients, evaluated for possible orthotopic liver transplantation (OLTx) underwent an upper gastrointestinal endoscopy for combined diagnostic and therapeutic purposes. The patients were divided into two main groups: 319 patients with parenchymal liver disease and 191 patients with cholestatic liver disease. Gastritis was found significantly more often in patients with parenchymal liver disease than in those with cholestatic liver disease (49.8% vs 30.9%; P <0.001). In contrast, the prevalence of esophagitis, esophageal and gastric varices, gastric ulcer, duodenal ulcer, and duodenitis was similar in both groups. Normal endoscopic findings were present in 5.0% of the parenchymal group and 11.5% of the cholestatic group (P <0.02). Ascites and encephalopathy were found significantly more often in subjects with parenchymal liver disease as compared to those with cholestatic liver disease. Portal hypertension and its degree, as assessed by the presence and size of esophageal varices, was similar in both groups, and in both groups there was a statistically significant qualitative trend of increasing prevalence of esophageal varices with increasing severity of disease as estimated using Pugh-Child's criteria.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, University of Pittsburgh School of Medicine, USA

    Mordechai Rabinovitz MD, Young-Kul Yoo MD, Robert R. Schade MD, Vincents J. Dindzans MD, David H. Van Thiel MD & Judith S. Gavaler PhD

  2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 15261, Pittsburgh, Pennsylvania

    Mordechai Rabinovitz MD, Young-Kul Yoo MD, Robert R. Schade MD, Vincents J. Dindzans MD, David H. Van Thiel MD & Judith S. Gavaler PhD

Authors
  1. Mordechai Rabinovitz MD
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  2. Young-Kul Yoo MD
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  3. Robert R. Schade MD
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  4. Vincents J. Dindzans MD
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  5. David H. Van Thiel MD
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  6. Judith S. Gavaler PhD
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Additional information

This work was supported in part by grant DK32556 from NIDDK, by grants AA06772 and AA06601 from NIAAA, and by a grant from the Gastroenterology Medical Research Foundation of Southwestern Pennsylvania.

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Rabinovitz, M., Yoo, YK., Schade, R.R. et al. Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively. Digest Dis Sci 35, 705–710 (1990). https://doi.org/10.1007/BF01540171

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  • DOI: https://doi.org/10.1007/BF01540171

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