A study of upper gastrointestinal endoscopy in management of acute upper gastrointestinal bleed (original) (raw)
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Internet Journal of Medical Update - EJOURNAL
Upper gastrointestinal bleed is defined as bleeding proximal to the ligament of Treitz. The aim of this study was to know the cause of upper GI bleed, prognosis of the patients and role of upper gastrointestinal endoscopy (UGIE) in the management of upper gastrointestinal bleed (UGIB). A study of 140 cases was carried out in the Shree Krishna Hospital and Pramukh Swami Medical College, Karamsad in India between January 2014 and June 2015. All patients were selected by the detailed history and physical examination. Patients with signs and symptoms suggestive of upper GI bleeding such as hematemesis, melena, blood in the nasogastric tubes, and profuse hematochezia were included in the study. Endoscopy was performed in all patients. Rockall scoring system was used to predict the mortality in patients with upper GI bleeding. We use descriptive statistics for analysis. It was found that upper GI bleed was more common in males than females, and was more prevalent in elderly individuals. The most common symptom was found to be hematemesis followed by abdominal pain. The most common cause was portal hypertension, which has a direct correlation with alcohol addiction. UGIE has both diagnostic as well as therapeutic role in UGIB. This study showed that upper GI bleeding was more common in male patients with the most common cause being portal hypertension. We observed that Mallory-Weiss tear had a particular association with NSAIDs. In our study, the Rockall scoring system was seen to predict the mortality in patients with upper GI bleeding. Endoscopy was both diagnostic and therapeutic and endoscopic variceal ligation (EVL/Glue) was performed for esophageal and/fundic varices and adrenaline injection for peptic ulcer bleeding and Mallory-Weiss tear.
Endoscopic profile and clinical outcome of patients presenting with upper gastrointestinal bleeding
International Journal of Advances in Medicine
Background: Acute upper gastrointestinal bleeding is a common medical emergency with significant mortality. The aim of the present study is to study endoscopic profile and clinical outcome of patients presenting with upper gastrointestinal bleeding in this region. Methods: This prospective observational study carried out on 100 patients admitted with upper gastrointestinal bleeding. All patients included in study underwent upper gastrointestinal endoscopy after initial evaluation and stabilization. Status of study group patients was noted at discharge. Patients were telephonically contacted at day 15 and were asked about rebleed, readmission for gastrointestinal bleed or death of the patient.Results: The mean age of patients was 48.98 ±14.50 years with male to female ratio of 2.57:1. The most common lesions causing UGI bleed were related to portal hypertension (esophageal and gastric varices) and were seen in 67% of patients. Non portal hypertensive lesions causing UGI bleed (pepti...
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Acute gastrointestinal (GI) bleeding is a lifethreatening emergency that remains a common cause of hospitalization worldwide. The aetiology of acute upper gastrointestinal bleed (UGIB) varies with each geographical region. Study aimed to analyse clinical profile, endoscopic profile and in-hospital mortality in patients with acute upper gastrointestinal bleeding. Material and methods: This was a retrospective analysis conducted in a Tertiary care centre in Bangalore. In this study we analysed the records of consecutive patients admitted with Upper Gastro-Intestinal bleeding over period of three years from January 2016 till January 2019. Results: We analysed two thirty consecutive patients diagnosed with acute upper gastrointestinal bleeding, 77.4% patients were males and 22.6% were females, mean age of presentation was 49.10 years. Most of the patients, one seventy-three (75%) were between the age group of 31-70 years. Melena was the most common symptom 80.4% followed by hematemesis 47%. History of chronic alcohol intake was noted in ninety three (40.4%) and smoking in sixty five (28.3%), medication history depicted that sixteen (6.92%) patients were on NSAIDS; fifteen (6.49%) patients were on anti-platelet drugs, five (2.1%) patients were on steroids, one (0.4%) patient was on Newer Oral Anti Coagulants. Conclusion: The present study reported peptic ulcer disease as the most common cause of upper GI bleeding, followed by portal hypertension related bleeding. The most common endoscopic lesions reported were esophageal varices, followed by duodenal ulcer. Upper G.I endoscopy is an important modality in both diagnosis and therapy in upper G.I bleed, concomitant medical and Endoscopic therapy may reduce mortality, morbidity and also the need for surgery/ interventional radiology assisted haemostasis.
Study of Clinical and Endoscopic Profile of Patients with Acute Upper Gastrointestinal Bleed
Journal of Medical Science And clinical Research, 2019
Background: Acute upper gastrointestinal bleeding is a common medical emergency with an estimated incidence of 50-150 cases per one lakh annually and it has been noted as a major cause of hospital admission and deaths worldwide ranging from 0.9% to 26.5%.Hence, this study was aimed to know the clinical and endoscopic profile of patients presenting with acute upper GI bleed to our hospital and their possible etiologies. Methods: This hospital based observational and cross-sectional study included sixty patients aged 18 years and above admitted in Department of General Medicine during the study period who presented with hematemesis or melena or both within 7 days. Results: Among 60 patients, males were predominant (86.7%). Mean age of presentation was 41.93 15.16 years. Most patients presented with both hematemesis and melena (51.7 %), 41.7 % patients had hematemesis only and 6.7 % patients had melena only. In our study, oesophageal varices were seen in 51.6 % patients, portal hypertensive gastropathy in 33.3 % patients, gastric ulcers in 11.7 % patients and duodenal ulcers in 5 % patients. Conclusion: The majority of patients belonged to age group of 31-40 years with a male predilection and variceal bleed was the most common cause of Upper GI bleeding.
Guidelines for endoscopic managements of non-variceal upper gastrointestinal bleeding
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2016
Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding using evidence-based methods. The major cause of non-variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, bleeding from drug-related ulcers has become predominant in comparison with bleeding from Helicobacter pylori-related ulcers in recent years in Japan, owing to an increase in the aging population and coverage of Helicobacter pylori eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first-line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's conditio...
Medical Clinics of North America, 2008
Upper gastrointestinal bleeding (UGIB) is a common, potentially lifethreatening condition responsible for more than 300,000 hospital admissions and about 30,000 deaths per annum in America [1]. Treating and preventing UGIB costs many billions of dollars per annum . Accurate patient evaluation and appropriate early management before esophagogastroduodenoscopy (EGD) is critical to decrease the morbidity and mortality. The early management focuses on resuscitative measures of fluid infusion or blood transfusion to reverse the direct consequences of bleeding; prevention of end-organ damage induced by the bleeding, such as hypoxia or prerenal azotemia; and general measures to promote hemostasis before EGD. Cliniciansdwhether internists, intensivists, gastroenterologists, or gastrointestinal surgeonsdhave to be familiar with the initial evaluation and therapy to form a knowledgeable and cohesive team. This article focuses on the initial assessment, early resuscitative measures, and general therapy of UGIB before EGD, with a focus on new techniques, to optimize the patient therapy and thereby decrease patient morbidity and mortality.
Upper Gastrointestinal Bleeding; Endoscopic Findings in Patients
THE PROFESSIONAL MEDICAL JOURNAL, 2017
… Background: Upper gastrointestinal bleeding (UGIB) is a common medical condition requiring mostly hospitalization and resuscitation. Patients with upper GI bleeding have high morbidity. The investigation of choice in upper GI bleeding is upper GI endoscopy, because endoscopy has good, the complication rate with endoscopy are low, another advantage of using endoscopy is therapeutic interventions as well. The causes of upper GI bleeding are numerous most frequent causes being in decreasing order of frequency peptic ulcer, esophageal varices, mallory-weis tears. Other causes include tumors, erosions and arterio-venous malformations. 3 Objectives: To determine the endoscopic findings in patients presenting with UGIB and frequency of various findings among these patients according to gender and age in medical ward of Allied Hospital Faisalabad. Study Design: Retrospectively reviewed and analyzed. Setting: Medical Unit 2 of Allied Hospital Faisalabad. Period: 06 month between January 2015 to June 2015. Methods: The record of 120 patients who underwent endoscopy for upper gastrointestinal bleeding. Results: Data was collected and entered on SPSS. Statistical data analysis was performed with chi-square. Statistical significance was determined at P< 0.05. Information obtained from upper gastrointestinal endoscopy were then recorded according to age, gender and presented in form of tables. Conclusions: It has been found that esophageal varices was the most commonest cause of upper gastrointestinal bleeding in the study probably due to the high prevalence of hepatitis infection and chronic liver disease in our population.
Upper gastrointestinal bleeding from the endoscopist’s view
Hellenic Journal of Surgery, 2010
Bleeding from the upper gastrointestinal tract is a frequent cause for emergency hospital admission that concerns both the endoscopist and general surgeon. Regarding the cause, peptic ulcers are the most frequent source of bleeding. Regarding severity, they range from simply a small episode to severe life-threatening hemorrhage. The aim of this article is to present current trends regarding optimal diagnostic work-up and therapeutic procedures for patients with upper gastrointestinal bleeding, especially those with severe haemorrhage, by a comprehensive review of the current literature.
Endoscopic findings in upper gastrointestinal bleeding patients at Tehran’s Taleghani Hospital, Iran
2016
Background: Upper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide and emergency medical condition that may require hospitalization. UGIB also increase the risk of morbidity, mortality and needs a health care resource use. To determine the endoscopic findings in patients with UGIB and its frequency among these patients according to age in Tehran’s Taleghani Hospital is the aim of this study. Materials and Methods: The medical records and endoscopy report of 990 patients were retrospectively analyzed, who underwent endoscopy for UGIB in Tehran’s Taleghani Hospital over a period of 2 years in 2010 to 2012. Results: A total of 990 patients had endoscopy for UGIB which consisted of 594 (60%) males and 396(40%) females. And mean age was 54 years ± 17.2 SD. The commonest cause of UGIB was peptic ulcer disease consisting of 52.2% that includes; duodenal ulcer (26.4%) and gastric ulcer with (19.1%), and then followed by esophageal and gastric varices (19.5%). The ...