Acute upper gastrointestinal bleeding in patients with portal hypertension: a correlation of endoscopic findings with etiology.

Esophagogastric variceal hemorrhage is a common cause of upper gastrointestinal bleeding in patients with portal hypertension. In addition, it is now recognized that patients with alcohol-induced chronic liver disease and portal hypertension frequently bleed from acute mucosal lesions. Since alcohol can cause these lesions in the absence of portal hypertension, we evaluated 28 episodes of upper gastrointestinal hemorrhage in patients with portal hypertension who did not consume alcohol. Varices were the source of blood loss in 86% of our cases, and no bleeding episodes were attributable to acute mucosal lesions. Acute mucosal lesions, therefore, appear to be uncommon causes of bleeding in nonalcoholic patients with portal hypertension.