Hepatitis B-related Cirrhosis Induced Upper Gastrointestinal Bleeding:a Case Report And Review Of Literature

OBJECTIVE:To analyze the experience in diagnosis and treatment of upper gastrointestinal bleeding resulted from Hepatitis B-related cirrhosis and discuss the mechanism. METHODS:A medical records about upper gastrointestinal bleeding resulted from esophageal and gastric cardia severe varices which complicated by liver cirrhosis was analyzed retrospectively and the literature was reviewed. DESIGN:Case report.PATIENT(S):The patient finds himself HBsAg positive for more than10years.On May2,2010, at11pm, he repeatedly vomiting blood with no obvious incentive, which were brown stomach contents.about400ml.He stools5times last night,the stools were dark red bloody, the total volume of about200ml. accompanied by fatigue, dizziness and discomfort. So he comes to our hospital on May3.INTERVENTION(S):The patient was given hepatoprotective,acid suppression. Hemostatic,anti-infection, nutrition support.at the same time give the combined treatment which included correction of anemia, anti-infection,and nutrition support in our department.Then he was transferred to the liver transplant ward to have the surgery of splenectomy and esophagogastric devascularization after his condition steadily. RESULT(S):At last.the patient with normal liver function and hemogram volume, Ascites subsided, Upper gastrointestinal bleeding stopped.CONCLUSION(S):For upper gastrointestinal bleeding resulted from Hepatitis B-related cirrhosis, should be given the surgery of esophagogastric devascularization and splenectomy (EGDS).conbined with anti-virus,anti-infective and lowering portal pressure, they are very important effective measures to critical patients.