scholarly journals Endoscopic Profile of the Patients with Upper Gastrointestinal Bleeding in a North–Eastern State of India - A Hospital-Based Cross-Sectional Study

2021 ◽  
Vol 8 (18) ◽  
pp. 1201-1205
Author(s):  
Koushik Chakma ◽  
Saumik Chakraborty ◽  
Avik Chakraborty

BACKGROUND Upper gastrointestinal bleeding (UGIB) is one of the common medical emergencies throughout the world that may require hospital admission and results in high patient morbidity and mortality. The presentation of UGI bleeding depends on the amount and location of haemorrhage. Upper gastrointestinal endoscopy (UGIE) is the preferred investigative procedure for UGIB because of its accuracy, low rate of complication, and its potential for therapeutic interventions. The present study has been carried out to evaluate the different aetiological causes of UGIB in a tertiary care centre in the North Eastern part of India and compare the same with other studies done globally. METHODS This was a hospital based observational study with cross sectional design carried out in the Department of Medicine at Tripura Medical College & DR BRAM Teaching Hospital, Agartala. Total 376 patients were selected for this study for over a period of 2 years from January 2017 to December 2018. Upper GI endoscopy was performed in all patients after hemodynamic stabilisation. Rockall scoring system was used in non-variceal cases to predict the mortality in patients with upper GI bleeding. RESULTS A total of 376 patients had endoscopy for UGIB which included 260 (69.1 %) males and 116 (30.9 %) females, and the mean age was 47.9 (± 17.0) years. The most common cause of UGIB was peptic ulcer disease (duodenal ulcer and gastric ulcer) consisting of 31.38 %, followed by erosive gastritis (23.94 %), oesophageal varix (11.17 %), portal hypertensive gastropathy (10.64 %), duodenitis (8.51 %). Gastrointestinal malignancy (gastric and oesophageal cancers) was reported in 3.98 % and rare causes of UGIB were Mallory-Weiss syndrome (1.86 %), and esophagitis (1.60 %). Among them 4.26 % of the patients had normal endoscopy findings. CONCLUSIONS In the present study, peptic ulcer disease was the most common cause of upper gastrointestinal bleeding, followed by erosive gastritis. Rockall score of more than 4 was numerically associated with increased incidence of mortality. KEYWORDS Upper Gastrointestinal Bleeding (UGIB), Upper Gastrointestinal Endoscopy (UGIE

1980 ◽  
Vol 66 (1) ◽  
pp. 11-14
Author(s):  
R.H. Hunt

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.


2019 ◽  
Vol 11 (2) ◽  
pp. 25-29
Author(s):  
Azizun Nessa ◽  
Muhammad Rabiul Hossain ◽  
Md Habibur Rahman ◽  
SM Mizanur Rahman ◽  
Abdullah Al Mamun ◽  
...  

Introduction: Dyspepsia affects up to 40% of the general population and significantly reduces the quality of life. Dyspeptic symptoms may be associated with endoscopically negative conditions, such as functional dyspepsia, or with organic lesions like peptic ulcer and oesophagitis which are easily detected by endoscopy. On the other hand, such lesions may also be asymptomatic and there is not always a clear cause and effect relationship between endoscopic findings and symptoms. Objective: To determine the prevalence of significant endoscopic lesion and or ultrasonographic findings and their association with dyspeptic symptoms in Bangladeshi rural population. Materials and Methods: This prospective cross sectional study was carried out in Nov 2015 to Dec 2015 in a field mobile hospital of Bangladesh Army, established in Daudkandi, Comilla where total 1094 uninvestigated dyspeptic patients were invited to participate in this cross sectional study and 105 typical dyspeptic patients were finally recruited as per Rome III criteria. Participants underwent clinical assessment through a preformed structured questionnaire and non video upper gastrointestinal endoscopy (UGIE) and ultrasonogram (USG) of hepatobiliary system (HBS). Results: The mean age of 105 participants (male-29; female-76) studied was 36.51±7.26 years with female preponderance (72.38%). Predominant symptoms were epigastric pain (69.52%), flatulence (34.28%), heart burn (28.57%) and diffuse abdominal pain (22.85%). Regarding treatment 48(45.71%) patients took proton pump inhibitors (PPI), 24 patients (22.85%) took H2 receptor blocker and 13 patients (12.38%) were on antacids irregularly. Seventeen patients (16.15%) had no history of medications for dyspepsia. Most of the patients (76.19%) had symptoms of less than 5 years. Organic dyspepsia was found in 68(64.76%) and functional dyspepsia in 37(35.23%) participants. Percentage of functional dyspepsia in male was 24.13% and in female it was 39.47% and the difference was statistically significant (p<0.05). In the organic dyspepsia group, upper GI endoscopy revealed 07(6.66%) duodenal ulcer, 02(1.9%) gastric ulcer, 04(3.8%) prepyloric ulcer and other inflammatory lesions like prepyloric gastritis in 46(43.80%) patients, antral gastritis in 06(5.7%) patients, duodenitis in 08(7.61%) patients and erosive oesophagitis in 03 patients(2.86%). Further USG revealed cholelithiasis in 02(1.90%) and gall bladder (GB) polyp in 01(0.95%) participants which could be the reason for their dyspeptic symptoms. Thirty Seven (35.23%) participants had normal UGIE (and also normal USG of HBS) but they had significant dyspeptic symptoms. Conclusion: Most of the patients (64.76%) in this study had significant upper GI endoscopic findings and labeled as organic dyspepsia and combined use of upper GI endoscopy and USG of HBS provided better yield for aetiological diagnosis of dyspepsia if there is any. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 25-29


e-CliniC ◽  
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Fadil Dewantara ◽  
Bradley J. Waleleng ◽  
Octavianus Umboh

Abstract: Gastrointestinal endoscopy in the upper gastrointestinal tract is performed to obtain the condition of gastrointestinal mucosa. This study was aimed to obtain the profile of UGIB among endoscopy patients at the Gastrointestinal Endoscopy Center of Prof. Dr. R. D. Kandou Hospital Manado from January 2016 to December 2017. This was a descriptive retrospective study using medical records of patients who were registered at the Gastro-intestinal Endoscopy Center from January 2016 to December 2017. The result shows that from 420 cases, there were 7 diagnoses after endoscopy, as follows: esophagitis, gastritis, erosive gastritis, gastric ulcer, gastric polyp, duodenitis, and hiatal hernia. The most common diagnosis of UGIB was gastritis in 155 cases (37%), esophagitis in 124 cases (30%), duodenitis in 40 cases (10%), gastric polyp in 36 cases (9%), hiatal hernia in 22 cases (5%), erosive gastritis in 21 cases (4%), gastric ulcer in 17 cases (4%), and the other diagnoses (varices esophagus, esophagus ulcer, duodenum ulcer, achalasia) in 5 cases (1%). UGIB occured more common in males with 227 cases (54%) compared to female with 193 cases (46%). The most frequent age group was 56-65 years old with 86 cases, and the most rare case was >75 years old. Conclusion: Upper gastrointestinal bleeding occured more common among males, aged 56-65 years. Gastritis was the most common diagnosis in endoscopy.Keywords: endoscopy, upper gastrointestinal bleeding Abstrak: Pemeriksaan endoskopi pada saluran cerna bagian atas berfungsi untuk mengeva-luasi keadaan mukosa saluran cerna atas dan sekitarnya. Penelitian ini bertujuan untuk mendapatkan profil gambaran endoskopi di Pusat Endoskopi KSM Ilmu Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2016 – Desember 2017. Jenis penelitian ialah deskriptif retroskpektif menggunakan data rekam medik pasien perdarahan SCBA yang melakukan pemeriksaan endoskopi periode Januari 2016 – Desember 2017. Hasil penelitian mendapatkan dari 420 kasus, ditemukan 7 diagnosis setelah tindakan endoskopi (EGD), yaitu esofagitis, gastritis, gastritis erosiva, gastric ulcer, polip gaster, duodenitis dan hernia hiatus. Diagnosis perdarahan SCBA terbanyak ialah gastritis 155 kasus (37%), esofagitis yaitu 124 kasus (30%), duodenitis 40 kasus (10%), polip gaster 36 kasus (9%), hiatus hernia 22 kasus (5%), gastritis erosiva 21 kasus (4%), gastric ulcer 17 kasus (4%), dan kasus dengan dignosis lainnya (varices esophagus, esophagus ulcer, duodenum ulcer, achalasia) sebanyak 5 kasus (1%). Perdarahan SCBA banyak terjadi pada pasien dengan jenis kelamin laki-laki berjumlah 227 pasien (54%) dibandingkan dengan pasien perempuan berjumlah 193 pasien (46%). Berdasarkan usia, terbanyak pada kelompok usia 56-65 tahun sebanyak 139 kasus dan terendah pada kelompok usia >75 tahun. Simpulan: Perdarahan SCBA lebih sering terjadi pada laki-laki, kelompok usia 56-65 tahun, dengan gastritis sebagai diagnosis terbanyak pada pasien perdarahan SCBA yang melakukan pemeriksaan endoskopi.Kata kunci: endoskopi (EGD), perdarahan SCBA


1970 ◽  
Vol 8 (2) ◽  
pp. 208-211 ◽  
Author(s):  
RB Gurung ◽  
G Joshi ◽  
N Gautam ◽  
P Pant ◽  
B Pokhrel ◽  
...  

Background: The upper gastrointestinal bleeding (UGIB) is defined as bleeding within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament of Treitz. It is one of the important medical emergencies worldwide. Objective: The objective of this study is to study the aetiology of upper gastrointestinal bleeding based on endoscopic examination findings in patients of various demographic characteristics. Materials and methods: This is a retrospective observational study. The endoscopic record book from 2007 January to 2009 October was reviewed for all the cases who underwent oesophago-gastro-duodenoscopic examination for upper GI bleeding. The clinico-epidemiological data of all the patients was reviewed and analyzed in concert with the aetiology of bleeding. Results: A total of 90 patients (58 males, 32 females; mean age 45.32+ 18.47 years) of upper gastrointestinal bleeding was studied and analyzed in terms of aetiology of bleeding and demographic profile. Among the ethnic groups, Aryan 46 (51%) was the most common ethnic group to have upper GI bleeding followed by Newars 24 (27%), Mongolians 16 (18%), Dalits 3 (3%) and others 1 (1%). Out of 90 patients, 47( 52.2%) cases was less than 45 years of age, 30(33.3%) of 46 to 65 age ; and 13(14.4 %) more than 65 years of age. Gastric ulcer 23(25.6%) was the most common endoscopic finding, followed by oesophageal varices 14 (15.6%), acute erosive/haemorrhagic gastropathy 11 (12.2%), duodenal ulcer 9(10%), growth 7(7.8%), vascular lesions 3(3.3%), Mallory-Weiss tear 1(1.1%), fundal varices 1(1.1%) and, no cause was identified in 21(23.3%) cases. The peptic ulcer bleeding was the most common finding in Aryan 22(47.9%), whereas oesophageal varices and growth were more common in Newar 7(29.2%) and 3 (12.5%) respectively. Conclusion: Peptic ulcer disease is the most common cause of upper GI bleeding which was most commonly found in Aryan population; followed by oesophageal varices and growth as second and third most common causes and were more prevalent in Newar and Mongolian people. Key words: Endoscopy; Peptic ulcer disease; Upper GI bleeding; Varices DOI: 10.3126/kumj.v8i2.3560 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 208-211


ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Fazl Q. Parray ◽  
Iqbal M. Lone ◽  
Nisar A. Chowdri ◽  
Imtiaz Wani ◽  
Mehmood A. Wani ◽  
...  

Duodenal gangliocytic paraganglioma (DGP) is a rare tumor that characteristically occurs in the second part of duodenum. These appear as submucosal masses that protrude into the lumen of a duodenum. Gastrointestinal bleeding is the commonest manifestation of DGP. Metastatic spread to regional lymph nodes occurs rarely. Surgical resection is the treatment of choice for DGP. A case of a DGP is reported in young female who presented with a recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy (UGIE) documented a mass in the ampullary region with ulceration in its middle which was bleeding. Recurrent gastrointestinal bleeding necessitated an emergency pancreaticoduodenectomy. Histopathology of specimen documented gangliocytic paraganglioma.


2017 ◽  
Vol 24 (02) ◽  
pp. 335-341
Author(s):  
Mughees Ather ◽  
Muhammad Sarfraz ◽  
Muhammad Zakria

Background: Upper gastrointestinal bleeding (UGIB) is a common medicalcondition requiring mostly hospitalization and resuscitation. Patients with upper GI bleedinghave 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, anotheradvantage of using endoscopy is therapeutic interventions as well. The causes of upper GIbleeding are numerous most frequent causes being in decreasing order of frequency pepticulcer, esophageal varices, mallory-weis tears. Other causes include tumors, erosions andarterio-venous malformations.3 Objectives: To determine the endoscopic findings in patientspresenting with UGIB and frequency of various findings among these patients according togender and age in medical ward of Allied Hospital Faisalabad. Study Design: Retrospectivelyreviewed and analyzed. Setting: Medical Unit 2 of Allied Hospital Faisalabad. Period: 06 monthbetween January 2015 to June 2015. Methods: The record of 120 patients who underwentendoscopy for upper gastrointestinal bleeding. Results: Data was collected and entered onSPSS. Statistical data analysis was performed with chi-square. Statistical significance wasdetermined at P< 0.05. Information obtained from upper gastrointestinal endoscopy werethen recorded according to age, gender and presented in form of tables. Conclusions: It hasbeen found that esophageal varices was the most commonest cause of upper gastrointestinalbleeding in the study probably due to the high prevalence of hepatitis infection and chronic liverdisease in our population.


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