Case Report: PDF OnlyNonalcoholic Fatty Liver Disease Manifesting Esophageal Variceal BleedingTang, Chia-Peia; Huang, Yi-Shina, *; Tsay, Shyh-Hawb; Chang, Full-Younga; Lee, Shou-DongaAuthor Information aDivision of Gastroenterology, Department of Medicine, Taipei, Taiwan, R.O.C. bDepartment of Pathology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. *Correspondence 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. E-mail: [email protected] Received: July 21, 2005; • Accepted: December 19, 2005. Journal of the Chinese Medical Association: April 2006 - Volume 69 - Issue 4 - p 175-178 doi: 10.1016/S1726-4901(09)70201-1 Metrics Abstract 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. © 2006 by Lippincott Williams & Wilkins, Inc.