Journal of the Chinese Medical Association
Volume 69, Issue 4 , Pages 175-178, April 2006

Nonalcoholic Fatty Liver Disease Manifesting Esophageal Variceal Bleeding

  • Chia-Pei Tang

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Yi-Shin Huang

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr. Yi-Shin Huang, Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Shyh-Haw Tsay

      Affiliations

    • Department of Pathology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Full-Young Chang

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Shou-Dong Lee

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei, Taiwan, R.O.C.

Received 21 July 2005; accepted 19 December 2005.

Article Outline

Nonalcoholic fatty liver disease (NAFLD) is a fatty liver disease occurring in patients without alcohol consumption. It includes a broad spectrum of liver disease, from fatty infiltration, inflammation and fibrosis, to cirrhosis, usually having obesity, hyperlipidemia, and diabetes mellitus as its etiology. NAFLD-related cirrhosis has rarely been reported in Taiwan. We herein report a 41-year-old male patient with nonalcoholic fatty liver cirrhosis (NAFLC), with the first clinical manifestation being bleeding esophageal varices (EV). The patient was obese with diabetes mellitus, but without hyperlipidemia or any history of drinking alcohol. The laboratory tests, abdominal sonography, and computed tomography revealed a typical case of liver cirrhosis. The pan-endoscopy disclosed EV with red-color sign. EV ligation was performed successfully to stop the bleeding. When the patient was in a stabilized clinical condition, a liver biopsy showed a typical histologic finding of NAFLD. Most of the cases of NAFLC reported in the literature have silent signs and symptoms. Sudden onset of the EV as the first clinical manifestation, as in this case, is rare. This case reminds us that NAFLD may indeed induce severe liver impairment, such as liver cirrhosis. Liver biochemical tests and abdominal sonography should be considered in patients with overt obesity and diabetes.

Key Words:  diabetes mellitus , esophageal varices , nonalcoholic fatty liver cirrhosis , nonalcoholic fatty liver disease , nonalcoholic steatohepatitis , obesity

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PII: S1726-4901(09)70201-1

doi:10.1016/S1726-4901(09)70201-1

Journal of the Chinese Medical Association
Volume 69, Issue 4 , Pages 175-178, April 2006

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