Authors: Camengo Police Serges Magloire, Youssouf Oumarou, Elowa Benoît, Mofini Eveline, Bessanguem Bernard, Puemeu Edna Nadège, Boua-Akelelo Nathalie Philomène, Service Georges, Koffi Boniface.
Objective: To determine the epidemiological, clinical and endoscopic characteristics of gastrointestinal bleeding in cirrhosis.
Patients and Methods: This was a retrospective analytical study lasting 51 months conducted in the Department of Hepato-gastroenterology and Internal Medicine of « l'Amitié Sino-centrafricaine » University Hospital Center Bangui, in Bangui. Included were patients of both sexes with cirrhosis in whom esogastroduodenal endoscopy was performed.
Results: A total of 2383 patients were hospitalized during the study period, including 250 (10.49%) for cirrhosis. One hundred and seven patients (4.5%) met our criteria. These were 58 cases (54.2%) of cirrhosis complicated by gastrointestinal bleeding and 49 cases (45.8%) of cirrhosis uncomplicated with bleeding. There were 73 men (68.2%) and 34 women (31.8%). The sex ratio was 2.15. The average age was 40 ± 13 years. The most common mode of expression of gastrointestinal bleeding was haematemesis and melena (79.3%). The Discontinuation of bêta-blocker therapy (p = 0.0004) and the use of nonsteroidal anti-inflammatory drugs (p = 0.0000) were risk factors for gastrointestinal bleeding. Cirrhosis was caused by the hepatitis B virus in 84 cases (78.5%). Hypovolemic shock was observed in 43 patients (40.2%) who presented with HD. The main endoscopic lesions responsible for the bleeding were VO (p = 0.001) and gastroduodenal erosions (p = 0.035). The hemorrhagic risk was linked to the size of the esophageal varices (EV) and the presence of red signs (p = 0.00005). Death was observed in 7 patients (6.5%).
Conclusion: Digestive hemorrhage (DH) is one of the frequent complications of cirrhosis, the primary cause of which is the rupture of the EV. Upper digestive endoscopy is essential in the event of suspicion of cirrhosis, in search of EV in order to begin primary prevention of their rupture according to the stage of severity.
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