Case: A 53-year-old man, was admitted to the hospital because of the huge ascites and general destruction. He had history of alcohol consumption about 80-120 gram/day for 20 years and he was heavy smoker – 20 cigarette/day for 20 years. The patient had suffered from cirrhosis of the liver for 5 years. Serology for viral hepatitis B and C were negative. During palpable examination, drew attention to the huge ascites (fig. 1).
A umbilical revealed the presence of varicose veins (fig. 2). The patient serum total bilirubin was 4.0 mg/dL, platelets – 11.000/mm 3 , white blood cells – 4.300/mm 3 , gamma glutamyltranspeptidase – 735 U/L, asparate aminotransferase – 40 U/L, alanine amnotranserase – 18 U/L. The Doppler ultrasound was performed. The superficial epigastric veins were enlarged during this examination. Upper gastrointestinal endoscopy showed grade 3 esophageal varices but with no…
