Publication:

Endoscopic profile and clinical outcome of patients presenting with upper gastrointestinal bleeding

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 (peptic and other lesions) were seen in 46% patients. Twenty six percent patients had combination of lesions while endoscopy was normal in 3% patients. Rebleeding within 15 days was seen in 11 patients out of whom 3 died during same admission. Out of other 8 patients with rebleed, readmission was seen in 6 patients while 2 patients had minor bleed. We found no correlation of mortality and rebleed with factors like age, history of liver disease, diabetes, NSAIDs use, peptic ulcer disease and presence of cirrhosis. However the correlation between rebleed and death was found to be statistically significant.

Conclusions Portal hypertension is the most common cause of upper gastrointestinal bleeding in this region. There is strong correlation between rebleeding and death. However there is no correlation between age, history of liver disease, diabetes, NSAIDs use, peptic ulcer disease and presence of cirrhosis with rebleed or mortality.