Korean J Med.  2014 Oct;87(4):449-454. 10.3904/kjm.2014.87.4.449.

Spontaneous Arterial Bleeding in Patients with Alcoholic Liver Cirrhosis: a Series of Three Cases

• Seon CS
• Jo Y
• Lee J
• Jo YK
• Ahn SB
• Son B
• Cho YK

• KMID: 2269220
• DOI: http://doi.org/10.3904/kjm.2014.87.4.449

Abstract

Spontaneous arterial bleeding has been reported rarely. In a patient consuming heavy amounts of alcohol with alcoholic liver cirrhosis, spontaneous bleeding can be evoked by thrombocytopenia, altered platelet function, and shear stress on fully dilated arteries by portal hypertension. Alcohol consumption itself can also predispose a patient to bleeding by influencing the aggregation and activation of platelets, and altering the coagulation and fibrinolysis pathway. All of these mechanisms could cause patients with alcoholic liver cirrhosis to bleed spontaneously; however, conditions inducing peripheral arterial bleeding are very rare. Here, we report three cases of spontaneous arterial bleeding in patients with liver cirrhosis consuming heavy amounts of alcohol. All of the patients bled without any physical trauma, and the involved arteries were the intercostal arteries in two cases and a gastroduodenal artery in the other case. The patients were treated by angiographic embolization. One expired due to recurrence of arterial bleeding despite repeated angiographic embolization and massive transfusion.

Keyword

Hemorrhage; Liver cirrhosis, alcoholic; Embolization, therapeutic

MeSH Terms

Alcohol Drinking
Arteries
Blood Platelets
Embolization, Therapeutic
Fibrinolysis
Hemorrhage*
Humans
Hypertension, Portal
Liver Cirrhosis
Liver Cirrhosis, Alcoholic*
Recurrence
Thrombocytopenia