A clinical study on etiology, prognosis, outcome and role of endoscopy in upper gastrointestinal bleed in a tertiary care center

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.Keywords: Upper GI bleeding; Endoscopy; Endoscopic variceal ligation; Mallory-Weiss tea

Upper Gastrointestinal Bleeding: Audit of a Single Center Experience in Western India

Upper gastrointestinal (GI) bleeding is defined as bleeding proximal to the ligament of Treitz. The most important aspect of management of GI bleeding is to locate the site and cause of bleeding. The aim of the study is to find out the common etiology, presentation and management, including the role of upper GI endoscopy. Recent advances have meant that endoscopic hemostatic methods are now associated with a reduced rate of re-bleeding, cost, blood transfusion, length of hospital stay and mortality. A prospective study of 50 cases was carried out between August 2001 and July 2003. Patients with signs and symptoms suggestive of upper GI bleeding (UGIB) such as hematemesis, melena, aspirated blood from nasogastric tubes, profuse hematochezia, etc., were included in the study. The patients were selected randomly. The most common cause of UGIB in the present study was acute erosive gastritis (34%) followed by portal hypertension (24%) and peptic ulcer (22%). All 50 patients underwent upper GI endoscopy, of whom 39 patients were treated conservatively and 11 patients underwent endotherapy to control bleeding. Out of 39 patients treated non-endoscopically, 6 cases required laparotomy to control UGIB. 8 of 50 cases had past history of UGIB, 5 of whom had a previous history of endotherapy. One case was treated with devascularization as routine hemostatic methods failed. So, initial method of choice to control the bleeding was endotherapy and surgery was undertaken if an endoscopic method failed. The most common cause of hematemesis in our setting was acute erosive gastritis followed by portal hypertension. Endoscopy is a valuable minimal invasive method to diagnose and treat upper GI bleeding

Upper gastrointestinal bleeding: audit of a single center experience in Western India

Upper gastrointestinal (GI) bleeding is defined as bleeding proximal to the ligament of Treitz. The most important aspect of management of GI bleeding is to locate the site and cause of bleeding. The aim of the study is to find out the common etiology, presentation and management, including the role of upper GI endoscopy. Recent advances have meant that endoscopic hemostatic methods are now associated with a reduced rate of re-bleeding, cost, blood transfusion, length of hospital stay and mortality. A prospective study of 50 cases was carried out between August 2001 and July 2003. Patients with signs and symptoms suggestive of upper GI bleeding (UGIB) such as hematemesis, melena, aspirated blood from nasogastric tubes, profuse hematochezia, etc., were included in the study. The patients were selected randomly. The most common cause of UGIB in the present study was acute erosive gastritis (34%) followed by portal hypertension (24%) and peptic ulcer (22%). All 50 patients underwent upper GI endoscopy, of whom 39 patients were treated conservatively and 11 patients underwent endotherapy to control bleeding. Out of 39 patients treated non-endoscopically, 6 cases required laparotomy to control UGIB. 8 of 50 cases had past history of UGIB, 5 of whom had a previous history of endotherapy. One case was treated with devascularization as routine hemostatic methods failed. So, initial method of choice to control the bleeding was endotherapy and surgery was undertaken if an endoscopic method failed. The most common cause of hematemesis in our setting was acute erosive gastritis followed by portal hypertension. Endoscopy is a valuable minimal invasive method to diagnose and treat upper GI bleeding