Clinical, Endoscopic Profile and Management of Patients with Upper Gastrointestinal Bleeding in Tertiary Care Center in Southern Karnataka

BACKGROUND: Performance of endoscopy within 24 h is recommended for patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB). It is unknown whether performing endoscopy early within this 24 h window is beneficial for clinically high-risk patients.METHODS: A retrospective review was performed to identify patients presenting to two tertiary care centres with ANVUGIB and either systolic blood pressure lower than 100 mmHg or heart rate greater than 100 beats/min on presentation between 1999 and 2004. Patients receiving endoscopy within 6 h (rapid endoscopy [RE]) were compared with patients undergoing endoscopy between 6 h and 24 h (early endoscopy [EE]). The primary outcome measure was the development of any adverse bleeding outcome (rebleeding, surgery for control of bleeding, in-hospital mortality or readmission within 30 days for ANVUGIB).RESULTS: There were 169 patients who met the entry criteria (77 RE patients and 92 EE patients). There was no significant difference in the development of any adverse bleeding outcomes between RE and EE patients (25% RE versus 23% EE, difference between groups 2%, 95% CI −9% to 13%). Transfusion requirements and length of hospital stay also did not differ between the comparator groups. RE was not associated with fewer adverse outcomes, even after adjusting for confounders.CONCLUSION: For clinically high-risk ANVUGIB patients, performing endoscopy within 6 h of presentation is no more effective than performing endoscopy between 6 h and 24 h after presentation. The role of RE in high-risk ANVUGIB patients requires further delineation in a prospective fashion.

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Acute upper gastrointestinal bleeding in a tertiary care hospital in South India - Have we Improved the outcomes?

Tropical gastrology ◽

10.7869/tg.350 ◽

2016 ◽

Vol 37 (3) ◽

Author(s):

Vishnu Prasad NR

Keyword(s):

Gastrointestinal Bleeding ◽

South India ◽

Upper Gastrointestinal Bleeding ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

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Treatment outcomes of patients with non-variceal upper gastrointestinal bleeding in emergency and critical care center

Nihon Kyukyu Igakukai Zasshi ◽

10.3893/jjaam.25.1 ◽

2014 ◽

Vol 25 (1) ◽

pp. 1-8

Author(s):

Makoto Onodera ◽

Yasuhisa Fujino ◽

Yoshihiro Inoue ◽

Satoshi Kikuchi ◽

Shigeatsu Endo

Keyword(s):

Critical Care ◽

Gastrointestinal Bleeding ◽

Treatment Outcomes ◽

Upper Gastrointestinal Bleeding ◽

Care Center ◽

Upper Gastrointestinal

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Early Endoscopic Findings in Patients with Upper Gastrointestinal Bleeding in Bangladesh

Bangladesh Critical Care Journal ◽

10.3329/bccj.v3i2.25112 ◽

2015 ◽

Vol 3 (2) ◽

pp. 60-62

Author(s):

Uzzwal Kumar Mallick ◽

Mohammad Omar Faruq ◽

SM Ishaque ◽

ASM Areef Ahsan ◽

Kaniz Fatema ◽

...

Keyword(s):

Duodenal Ulcer ◽

Gastric Ulcer ◽

Gastrointestinal Bleeding ◽

Esophageal Varices ◽

Upper Gastrointestinal Bleeding ◽

Tertiary Care ◽

Care Hospital ◽

Stomal Ulcer ◽

Female Ratio ◽

Upper Gastrointestinal

Objective: To determine etiological pattern of patients presenting with upper gastrointestinal bleeding in a tertiary care hospital of Bangladesh.Methods: This study was a prospective observational study, carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to June 2013. Fifty adult patients presenting with haematemesis and/or melaena admitted into gastroenterology inpatient unit from outpatient department or patients referred from other inpatient units of Department of Medicine of BSMMU were included in the study. Endoscopic examination was performed within 24 to 48 hours of presentation. Lower GI endoscopy was done in selected cases.Results: The study patients were predominantly young or of early middle age with mean age being 34.45 ± 16.5 yrs. A male preponderance was observed with male to female ratio being 7.3:1 (44 male and 6 female). 62% of the patients presented with both haematemesis and melaena, 26% with melaena only and 12% with haematemesis alone. Endoscopy of upper gastrointestinal tract demonstrated duodenal ulcer to be predominant finding (50%), followed by gastro-esophageal erosions (20%), gastric ulcer (12%), esophageal varices (10%), gastric adenocarcinoma (4%) and stomal ulcer (4%).Conclusions: Endoscopy revealed that duodenal ulcer was the most common cause of upper gastrointestinal bleeding followed by oesophageal erosion, gastric ulcer, esophageal varices and stomal ulcer. Peptic ulcer disease still remains as the major cause of acute upper gastrointestinal haemorrhage, though cases of oesophageal erosion were also significant.Bangladesh Crit Care J September 2015; 3 (2): 60-62

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Clinical and endoscopic profile of patients with upper gastrointestinal bleeding at tertiary care center of North India

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.150660 ◽

2014 ◽

Vol 05 (04) ◽

pp. 139-143 ◽

Cited By ~ 6

Author(s):

Deep Anand ◽

Rohit Gupta ◽

Minakshi Dhar ◽

Vivek Ahuja

Keyword(s):

Peptic Ulcer ◽

Portal Hypertension ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Tertiary Care ◽

North India ◽

Medical Emergency ◽

Female Ratio ◽

Common Cause ◽

Upper Gastrointestinal

Abstract Background: Upper gastrointestinal bleeding (UGIB) is a common medical emergency associated with significant morbidity and mortality. The presentation of bleeding depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. Despite advancements in medical intervention UGIB still carries considerable morbidity, mortality and economic burden on health care system. At present, there is limited epidemiological data on UGIB and associated mortality from India. Aims: The aim was to study clinical, endoscopic profile, and associated mortality in patients presenting with UGIB. Materials and Methods: One hundred and fourteen patients came to Emergency Department with UGIB during the study period and were subjected to endoscopy to identify the etiology. The clinical and endoscopic profile was analyzed and mortality pattern was studied. Results: The mean age of patients was 49 ± 14.26. Majority of them were males (83.33%) and male to female ratio was 5:1. The most common cause of UGIB was portal hypertension related (Esophageal and gastric varices) seen in 56.14% of patients, peptic ulcer-related bleed was seen in 14.91% patients, gastric erosions were responsible for bleed in 12.28% patients, Mallory–Weiss tear was seen in 8.77% cases, gastric malignancy accounted for 4.38% of cases, Dieulafoy’s lesion was responsible for bleed in 1.75% cases and 1.75% had Duodenal polyp. The mortality rate because of UGIB in our cohort of patients was 21.05%. Conclusions: In the present study, variceal bleed was the most common cause of UGIB, followed by peptic ulcer bleed. Overall mortality was seen in 21.05% of cases; however, majority of mortality was seen in portal hypertension related bleeding.

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