[Importance of disorders of primary hemostasis in the occurrence of upper digestive hemorrhage in cirrhosis].
In order to assess the true incidence of haemostatic disorders in cirrhotic gastro-intestinal haemorrhage, a comparative prospective study of primary haemostasis, coagulation and fibrinolysis was carried out in 37 patients distributed into two groups: cirrhotics with gastro-oesophageal varices that had never bled (Group A = 22), and cirrhotics who had had an intestinal bleed from "ruptured" gastro-oesophageal varices (Group B = 15). Combination of thrombocytopenia (less than 100 10(9)/l) and a bleeding time greater than 8 mn was more frequent in Group B (80%) than in Group A (45%) (p = less than 0.05). On the other hand, no significant difference between the two groups was found in the activated cephalin time, thrombin time, prothrombin complex factors (II, V, VII-X), fibrinogen, antithrombin III, Factor VIII complex factors, FDP levels or plasminogen. In conclusion, these results suggest that disorders of primary haemostasis may be involved in bleeding from gastro-intestinal varices in cirrhosis. However, coagulation disorders and anomalies of fibrinolysis would not seem to play a determining role.
D001760:Bleeding Time; D001778:Blood Coagulation Disorders / Q000097:blood*; D001779:Blood Coagulation Factors / Q000032:analysis; D004932:Esophageal and Gastric Varices / Q000097:blood*; D005260:Female; D005342:Fibrinolysis; D006471:Gastrointestinal Hemorrhage / Q000097:blood; D006487:Hemostasis; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies
D001779:Blood Coagulation Factors
Importance des troubles de l'hémostase primaire dans la survenue des hémorragies digestives hautes du cirrhotique.