Frequency of fundal varices in cirrhotic patients with upper gastrointestinal bleed.

  • Waseem Sarwar Malghani Nishtar Medical University Multan
  • Farooq Mohyud Din Chaudhary Nishtar Medical University, Multan.
  • Asim Tameez Ud Din Benazir Bhutto Hospital, Rawalpindi.
  • Sana Mohyud Din Chaudhary Ibn-E-Siena Hospital, Multan.
  • Asma Tameez Ud Din CMH Multan.
Keywords: Cirrhosis, Fundal Varices, Portal Hypertension, Upper Gastrointestinal Bleeding


Objectives: Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency in cirrhosis. These patients mainly bleed from esophageal varices. The aim of the present work was to determine the prevalence of fundal varices; gastro-oesophageal varices type2 (GOV-2) and isolated gastric varices type1 (IGV-1), as a cause of AUGIB. Study Design: Cross-sectional study. Setting: Gastroenterology Department of Nishtar Hospital Multan, Pakistan, using non-probability consecutive sampling. Period: July to December 2018. Material and Methods: Emergency upper gastrointestinal (UGI) endoscopy was performed in 165 cirrhotic patients and the findings documented. Results: The mean age was 50.15 ± 12.72 years. There were 103 (62.4%) males and 62 (37.6%) females (p<0.0001). Hepatitis C virus (HCV) was the cause of cirrhosis in 75%, followed by HBV in 10% and HBV & HCV co-infection in 6%. Bleeding fundal varices were found in 25 (15%) patients, 15 IGV-1 and 10 GOV-2. Other major causes of bleeding included: esophageal varices 93 (56.4%) and portal hypertensive gastropathy (PHG) 33 (20%). All fundal varices were found in advanced liver disease patients (p<0.05). Conclusion: AUGIB is more common in males and advance liver disease. Although not frequent, fundal varices are an important cause of AUGIB, with a strong association with severity of cirrhosis. Our study demonstrates a higher prevalence of fundal varices (especially IGV-1) than other studies.

Author Biographies

Waseem Sarwar Malghani, Nishtar Medical University Multan

MBBS, FCPS Medicine, FCPS Gastroenterology

Assistant Professor

Department of Gastroenterology


Farooq Mohyud Din Chaudhary, Nishtar Medical University, Multan.


MRCP (London), ESEGH (UK),

Fellow of Gastroenterology


Asim Tameez Ud Din, Benazir Bhutto Hospital, Rawalpindi.


House Officer


Sana Mohyud Din Chaudhary, Ibn-E-Siena Hospital, Multan.


House Officer


Asma Tameez Ud Din, CMH Multan.



Department of Hematologist,