Assessment Of Adrenal Function In Patients With Liver Cirrhosis After Variceal Bleeding

Patients with liver cirrhosis commonly have abnormalities in adrenal function. Adrenal insufficiency is common in critically ill patients with liver cirrhosis,especially variceal bleeding.The aim of this study is to assess adrenal function in cirrhotic patients after variceal bleeding and if there is relationship between the severity of liver disease and adrenal insufficiency.A total of 60 patients with liver cirrhosis selected from about five hundred Patients with liver cirrhosis enrolled in this study were classified in to two groups: The first group (none bleeders): 30 stable patients with liver cirrhosis without variceal bleeding and no history of variceal bleeding; were classified according to modified Child-Pugh classification into: Child A, B and C (each subgroup includes 10 patients),The second group (bleeders): the other 30 patients with liver cirrhosis after first attack of variceal bleeding; were also classified according to modified Child-Pugh classification into: Child A, B and C (each subgroup includes 10 patients).We divided the study population, according to timing of ACTH injection (Synacthen) into: sample I (at 8 AM before ACTH injection), sample II (after half an hour from ACTH injection) and sample III (after one hour from ACTH injection).Our results showed a clear relationship between the severity of liver disease and adrenal insufficiency.