الفهرس 
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Abstract
Introduction:
Liver cirrhosis is a major health problem in Egypt, especially complicating viral hepatitis (El-Zayadi et al., 2005).
Upper gastrointestinal bleeding (UGIB) is a major public health problem, its prevalence being 100-170:100,000 population (Palmer KR, 2002). Despite major advances in diagnosis and treatment, Upper gastrointestinal bleeding remains a serious problem in clinical practice, with a mortality of 3%-14%, unchanged in the past 10 years (Sostres C, Lanas A, 2011).
Causes of UGIB can be grouped into two categories: variceal (esophageal or gastric varices) and non-variceal (peptic ulcer, erosive gastritis, reflux esophagitis, Mallory-Weiss syndrome, tumors, etc). Emergency upper gastrointestinal endoscopy is the standard procedure recommended for both diagnosis and treatment of UGIB (Biecker E, 2013).
In cirrhotic patients, variceal bleeding is 60-65% of the bleeding episodes in these patients. Bleeding from esophageal varices is only 5-11% of all gastrointestinal hemorrhage cases. In the U.S. about 30% of the patients with compensated cirrhosis have esophageal varices when first diagnosed (D’Amico G, Garcia Tsao G, Cales P, et al, 2001).
Upper gastrointestinal bleeding in cirrhotic patients occurs mainly from esophageal and gastric varices. However, there are numerous cases of non-variceal bleeding in cirrhotic patients. For this reason, the present paper aims to analyze the etiology of non-variceal bleeding in patients with cirrhosis.
- Aim of the work:
We aim to investigate the etiology of non-variceal bleeding in patients with liver cirrhosis.
Patient &methods:-
The study was conducted on 60 Cirrhotic patients presented with upper gastrointestinal bleeding admitted to Internal medicine department of Sohag University Hospital were enrolled in this study. The diagnosis of cirrhosis was based on clinical features, laboratory test, imaging diagnostics, and liver histology whenever possible.
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- Results:
As regard the cause of upper GI bleeding according to the endoscopy findings of our studied patients, there were 14 patients (23.3%) had duodenal ulcer, and most frequent cause was the Gastric ulcer which present in 19 patients (31.7%), While 13 patients had Portal Hypertensive Gastropathy, 6 patients (10%) had Acute Erosive Gastritis, 4 (6.7%) patients had Esophageal Ulcer, and both Mallory-Weiss syndrome and Gastric tumors are present in 2 patients for each cause.
Conclusion:-
There are numerous causes of non-variceal upper gastrointestinal bleeding in cirrhotic patients. That should be suspected, screened and properly managed in these patients.