Plasma level of endogenous heparinoids (heparan sulphate) and its relation to bleeding esophageal

grade III O.V and serum heparan sulphate was measured in all. Results: Introduction and aim: bleeding from esophageal varices may occur unpredictably and infrequently in Individual patients but the cause is unknown. In cirrhotic patients there is an increased risk to bacterial infection. Bacterial infection has been associated with failure to control bleeding, more early rebleeding.this study amis to assess changes in the serum level of heparan sulphate as an endogenous heparinoids and their relation to infection and induction of variceal bleeding in cirrhotic patients. Patients and methods: this study included 60 patients and 10 controls, the patients were classified into 50 patients with child’s (A) and 10 patients with other child’s, they were further divided into two subgroups: infected and non infected according to history, clinical examination and investigation as chest x ray, urine analysis, stool analysis, peritoneal fluid examination and blood culture. All patients underwent upper GIT endoscopy and selected there was significant difference in level of heparan sulphate between hepatic patient and control, asignificant difference between infected and non infected cases as regard heparan sulphate. Also there was a significant difference between different groups and subgroups of study. Child’s (C) group had higher levels than child’s (B&A). Also infected patients had significant prolongation of duration of bleeding than non-infected. Significant relation between different levels of shock and heparan was found where no relation to bleeding or recurrence or special infection or organism. Conclusion: heparan sulphte (endogenous heparinoid) is raised in hepatic patients due to decreased metabolism and infection.