Upper Gastrointestinal Bleeding in a Patient with a History of Peptic Ulcer Disease: Donʼt Presume the Diagnosis

2010 ◽  
Vol 103 (2) ◽  
pp. 181-182
Author(s):  
Nishant Tageja ◽  
Saurabh Sethi ◽  
Ankit Rathod
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Upper Gastrointestinal Bleeding ◽  
Ulcer Disease ◽  
History Of ◽  
Upper Gastrointestinal

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

2020 ◽  
Vol 7 (9) ◽  
pp. 1355
Author(s):  
Ashish Kumar ◽  
Umang Kasturi ◽  
Amritpal Singh ◽  
Dharamjit Kaur
Keyword(s):  
Peptic Ulcer ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Clinical Outcome ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Upper Gastrointestinal Bleeding ◽  
Ulcer Disease ◽  
History Of ◽  
Upper Gastrointestinal

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.

Not so Goody’s powder

2021 ◽  
Vol 14 (7) ◽  
pp. e242055
Author(s):  
Raja Samir Khan ◽  
Sardar Momin Shah-Khan ◽  
Justin Kupec
Keyword(s):  
Peptic Ulcer ◽  
Adverse Effects ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Upper Gastrointestinal Bleeding ◽  
Gastrocolic Fistula ◽  
Over The Counter ◽  
Ulcer Disease ◽  
Upper Gastrointestinal ◽  
Acute Anaemia

Over-the-counter analgesic medications are widely used amongst American adults and are also available in powder forms. Their adverse effects have been well documented in literature. Gastrocolic fistulas as a complication of peptic ulcer disease from analgesic powder usage have been previously unreported. Here, we report a patient with upper gastrointestinal bleeding and acute anaemia secondary to peptic ulcer complicated by gastrocolic fistula in a patient using analgesic powder.

scholarly journals EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING SECONDARY TO PEPTIC DISEASE IN A TERTIARY REFERRAL BRAZILIAN HOSPITAL

2021 ◽  
Author(s):  
Marcela FORGERINI ◽  
Gustavo URBANO ◽  
Tales Rubens de NADAI ◽  
Maruxa ZAPATA-CACHAFEIRO ◽  
Rafael KEMP ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Clinical Symptoms ◽  
Upper Gastrointestinal Bleeding ◽  
Oral Anticoagulants ◽  
Tertiary Referral ◽  
Ulcer Disease ◽  
Number Of Patients ◽  
Upper Gastrointestinal

ABSTRACT BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions. OBJECTIVE: To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease. METHODS: Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period. RESULTS: A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was 7.1%. The annual frequency of diagnosis between 2017 and 2019 ranged from 9.3% to 5.7%. Most patients were men (72.8%); self-declared white (71.8%); older people (56.7%); and, had no familiar or personal history of gastrointestinal diseases (60.1%). 90% of the patients had a peptic ulcer and melena (62.8%). Patients made chronic use of low-dose aspirin (29.3%), other antiplatelet agents (21.9%) and, oral anticoagulants (11.2%); and non-steroidal anti-inflammatories use in the week a prior to the onset of clinical symptoms (25.8%). CONCLUSION: Seven in every 100 patients admitted and underwent UGE in a tertiary hospital were diagnosed with NVUGIB secondary to peptic ulcer disease.

scholarly journals Upper GI bleeding: Causes, morbidity and mortality in admitted patients at Tertiary Care Hospital of Karachi.

2019 ◽  
Vol 26 (11) ◽  
pp. 1916-1924
Author(s):  
Naresh Kumar Seetlani ◽  
Khalid Imran ◽  
Pooja Deepak ◽  
Fizza Tariq ◽  
Daniyal Mirza ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Scoring System ◽  
Upper Gastrointestinal Bleeding ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Ulcer Disease ◽  
Variceal Bleed ◽  
Upper Gastrointestinal

Objectives: Acute upper gastrointestinal bleed is one of the most common emergencies. Despite advancement in the medical field, gastrointestinal bleeding still carries significant mortality and fiscal burden on healthcare system. At present, limited data is available on the predictors of morbidity and mortality associated with acute upper gastrointestinal bleeding in our part of the country. Study Design: Descriptive analytical study. Setting: Medical wards of Civil Hospital Karachi. Period: From January 2018 to June 2018. Material and Methods: 260 patients of 12 years and above with complaint of upper gastrointestinal bleeding. After hemodynamic stabilization, patients were referred to undergo esophago-gastro-duodenoscopy at the endoscopy suite of the hospital. Their personal data and endoscopic findings were recorded after obtaining a written consent. The patients were followed for 2 weeks to document the factors leading to their morbidity and mortality. We used Rockall scoring system to identify risk of patient mortality. Data collected was analyzed using SPSS 22·0. Results: The survey included 260 patients having males (62·3%) more than females (37·7%) with age ranging from 12 to 85 years. Among all, variceal bleed was accounted in 186 (71·5%) patients while remaining 74 (28·4%) patients had non-variceal bleed; peptic ulcer disease being the most common etiology. The overall mortality rate of our study was 5·76%. Some factors influencing mortality of the patients were age > 60 years, comorbid, use of NSAIDS, rebleeding, deranged laboratory tests at the time of presentation- anemia (hemoglobin of < 10 g\dl), grade 3 thrombocytopenia (platelet count of < 50 cells\dl), serum creatinine > 1·5 and serum INR of > 1·6. Additionally, a direct proportion was seen in between Rockall scoring system and patient mortality with a significant p-value (0·000). Conclusion: In this study, variceal bleeding was found as the predominant lesion of upper gastro-intestinal bleeding followed by peptic ulcer disease. Certain factors are found that are strongly related in deteriorating patient’s outcome. Along with it, Rockall score is also a good predictor of outcome of patients.

Stopping antithrombotic therapy after acute upper gastrointestinal bleeding is associated with reduced survival

2017 ◽  
Vol 94 (1109) ◽  
pp. 137-142 ◽  
Author(s):  
Keith Siau ◽  
Jack L Hannah ◽  
James Hodson ◽  
Monika Widlak ◽  
Neeraj Bhala ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Adverse Events ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Antithrombotic Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
University Hospital ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

IntroductionAntithrombotic drugs are often stopped following acute upper gastrointestinal bleeding (AUGIB) and frequently not restarted. The practice of antithrombotic discontinuation on discharge and its impact on outcomes are unclear.ObjectiveTo assess whether restarting antithrombotic therapy, prior to hospital discharge for AUGIB, affected clinical outcomes.DesignRetrospective cohort study.SettingUniversity hospital between May 2013 and November 2014, with median follow-up of 259 days.PatientsPatients who underwent gastroscopy for AUGIB while on antithrombotic therapy.InterventionsContinuation or cessation of antithrombotic(s) at discharge.Main outcomes measuresCause-specific mortality, thrombotic events, rebleeding and serious adverse events (any of the above).ResultsOf 118 patients analysed, antithrombotic treatment was stopped in 58 (49.2%). Older age, aspirin monotherapy and peptic ulcer disease were significant predictors of antithrombotic discontinuation, whereas dual antiplatelet use predicted antithrombotic maintenance. The 1-year postdischarge mortality rate was 11.3%, with deaths mainly due to thrombotic causes. Stopping antithrombotic therapy at the time of discharge was associated with increased mortality (HR 3.32; 95% CI 1.07 to 10.31, P=0.027), thrombotic events (HR 5.77; 95% CI 1.26 to 26.35, P=0.010) and overall adverse events (HR 2.98; 95% CI 1.32 to 6.74, P=0.006), with effects persisting after multivariable adjustment for age and peptic ulcer disease. On subgroup analysis, the thromboprotective benefit remained significant with continuation of non-aspirin regimens (P=0.016). There were no significant differences in postdischarge bleeding rates between groups (HR 3.43, 0.36 to 33.04, P=0.255).ConclusionIn this hospital-based study, discontinuation of antithrombotic therapy is associated with increased thrombotic events and reduced survival.

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