A study of upper gastrointestinal endoscopy in management of acute upper gastrointestinal bleed

Background: Upper gastrointestinal bleeding (UGIB) is life threatening emergency that remains a common cause of hospitalization worldwide. In spite of tremendous advancement in management of upper gastrointestinal bleeding (UGIB) over past two decades, it carries considerable mortality, morbidity. The present study was undertaken to know the clinical profile, endoscopic profile, intervention, outcome and mortality of upper GI bleed.Methods: A total of 110 patients of UGIB were evaluated over a period of 30 months for etiology of UGIB like peptic ulcer, variceal bleeding, gastritis, Barrett’s esophagus and malignancy. Therapeutic Intervention (Band ligation, glue injection, clipping etc.) was done as required on case to case basis.Results: Hematemesis was the most common symptom with 62(56.36%) patients. 85(77.27%) patients were presented during first episode of their bleeding. Esophageal varices 50 (45.45%) was the most common diagnosis and the most common past history was alcohol intake 48 (43.63%). 55 (50%) patients required only medical (Pharmacological) management and 50 (44.54%) patients require endoscopic management. 102 (92.72%) were improved and subsequently discharged while 8 (7.27%) patients expired during the course of treatment.Conclusions: Endoscopic examination is an important modality in both diagnosis and managing UGIB and helps to reduce morbidity, mortality and also need for surgery of the disease significantly.

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The Diagnosis and Prognosis of Upper Gastrointestinal Haemorrhage

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-66-11 ◽

1980 ◽

Vol 66 (1) ◽

pp. 11-14

Author(s):

R.H. Hunt

Keyword(s):

Gastrointestinal Bleeding ◽

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Bleeding ◽

Gastrointestinal Haemorrhage ◽

Accurate Diagnosis ◽

Upper Gastrointestinal Endoscopy ◽

The Past ◽

Diagnosis And Prognosis ◽

Upper Gastrointestinal ◽

Overall Mortality

AbstractThere have been major advances in the diagnosis and management of upper gastrointestinal bleeding over the past two decades but the overall mortality figure remains about 10 per cent. This paper reviews the place of upper gastrointestinal endoscopy in diagnosis and discusses the argument that this form of earlier, more accurate diagnosis has had no influence on the outcome of the condition.

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Acute upper gastrointestinal bleeding: endoscopic assessment and treatment

Gastrointestinal Nursing ◽

10.12968/gasn.2020.18.sup1.s26 ◽

2020 ◽

Vol 18 (Sup1) ◽

pp. S26-S35

Author(s):

Rajan Patel ◽

Steven Mann

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal Endoscopy ◽

Acute Upper Gastrointestinal Bleeding ◽

Assessment And Treatment ◽

Medical Emergencies ◽

The Uk ◽

Endoscopic Assessment ◽

Upper Gastrointestinal ◽

Significant Mortality

Acute upper gastrointestinal bleeding (AUGIB) represents 10% of medical emergencies in the UK and is associated with a significant mortality risk. Mortality has remained steady over the past 2 decades, at approximately 10%, with over 4000 deaths per annum in the UK. Patients with significant bleeding present with symptoms of haematemesis, melaena or haematochezia (rapid transit of red blood through the GI tract). An assessment of haemodynamic stability along with adequate resuscitation is vital prior to performing safe endoscopy. The performance of prompt upper gastrointestinal endoscopy is then necessary, as it has diagnostic, prognostic and therapeutic roles. Early identification of aetiology (variceal versus non-variceal bleeding) is important and directs endoscopic and medical treatment. An increasing number of endoscopic therapeutic options are now available.

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Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Gut ◽

10.1136/gutjnl-2018-316276 ◽

2018 ◽

Vol 67 (10) ◽

pp. 1757-1768 ◽

Cited By ~ 52

Author(s):

Joseph JY Sung ◽

Philip WY Chiu ◽

Francis K L Chan ◽

James YW Lau ◽

Khean-lee Goh ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Working Group ◽

Upper Gastrointestinal Bleeding ◽

Endoscopic Therapy ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Asia Pacific ◽

Endoscopic Management ◽

Three Stages ◽

Upper Gastrointestinal

Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the ’gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement.

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