scholarly journals Causes of Upper GI Bleed: Variceal or non-variceal.

2020 ◽  
Vol 27 (04) ◽  
pp. 820-824
Author(s):  
Talha Munir ◽  
Muhammad Naeem Safdar ◽  
Salman Azhar ◽  
Rizwan Rasool Khan ◽  
Samara Siddique ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Tertiary Care ◽  
Care Hospital ◽  
Gi Bleeding ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Variceal Bleed ◽  
Gi Bleed

Objectives: To determine the frequency of esophageal variceal bleed in patients with upper GI bleed presenting in a tertiary care hospital. Study Design: Cross sectional survey. Setting: Department of Medicine, Mayo Hospital, Lahore and Madinah Teaching Hospital, Faisalabad. Period: 6 months from 01-06-2018 to 31-12-2018. Material & Methods: Two hundred patients with upper GI bleed were included in the study. All the patients had upper GI endoscopy to determine the esophageal variceal bleeding which was documented as frequency distribution table. Results: Esophageal variceal bleed was seen among 108 (54%) patients while it was not present among 92 (46%) patients. Conclusion: Esophageal variceal bleeding is frequently present among patients with upper GI bleeding and should be suspected in every patient with upper GI bleeding.

scholarly journals Clinical profile of patients presenting with gastrointestinal bleeding in a tertiary care hospital

2017 ◽  
Vol 4 (6) ◽  
pp. 1616
Author(s):  
Chandan Kumar ◽  
Sumit Kumar Chakrabarti ◽  
Sucharita Chakraborty ◽  
Keshab Sinharay
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Oesophageal Varices ◽  
Care Hospital ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Gi Bleed

Background: It has been seen that Upper gastrointestinal bleeding (UGIB) is one of the most mutual gastrointestinal emergencies for physicians and surgeons. In the recent past studies, there is raised incidence of peptic ulcer with raised frequency of bleeding from it. The range of upper GI bleeding fluctuates from region to region and relies on the status of the centre in hospital hierarchy.Methods: An observational, cross-sectional, hospital-based, single centre study was carried out on 150 patients admitted in tertiary care hospital with the presentation of GI bleeding. A detailed patient history was taken followed by required clinical and laboratory investigations. Then patients were resuscitated and subjected to endoscopic procedure.Results: 150 patients were treated among which 105 were male (70%) and 45 females (30%). 111 patients (74%) had upper GI bleed, 28 patients (19%) had lower GI bleed, and 11 patients (7%) had obscure bleed. 41% of the population were diagnosed to have peptic ulcer (gastric or duodenal) as the cause behind GI bleed forming the main aetiology in this study population, 26% had oesophageal varices constituting second important cause of GI bleed, and 7% had obscure bleed. Those who had undergone UGI endoscopy or sigmoidoscopy or colonoscopy within last one month and who were having GI bleed following GI surgery were excluded from the study.Conclusions: It was seen that upper GI bleeding is more common than lower GI bleeding. Peptic ulcer was the chief cause resulting in gastrointestinal bleed followed by oesophageal varices. Gastrointestinal bleeding was more common in male population affecting mainly subjects over 40 years of age.

scholarly journals S0631 Performance of Upper GI Bleeding Scores in a Large Tertiary Care Hospital

2020 ◽  
Vol 115 (1) ◽  
pp. S316-S316
Author(s):  
Yousef Fazel ◽  
Muhammad Tahir ◽  
Randy Cheung ◽  
Gina Sparacino ◽  
Sarah Sadek ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Large Tertiary Care

scholarly journals Seasonal variation in acute variceal upper gastrointestinal tract bleeding: Experience of one decade from Northern India

2021 ◽  
Vol 12 (8) ◽  
pp. 76-80
Author(s):  
Shabir Ahmad Shiekh ◽  
Ali Imran ◽  
Showkat Ahmad Kadla ◽  
Mohammad Yasin ◽  
Bilal Ahmad Khan ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Demographic Data ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Gastrointestinal Bleed ◽  
Northern India ◽  
Variceal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
The World ◽  
Upper Gastrointestinal

Background: There have been several reports of seasonal variations in the incidence of esophageal variceal bleeding but the data available from this part of the world is scanty. Aims and Objective: We aimed to study whether monthly and seasonal climatic changes during the year have an influence on the incidence of variceal bleeding in our setting and whether a particular time in the year can be defined as a high-risk period for variceal bleed. Materials and Methods: Data of all the patients with diagnosis of acute variceal upper gastrointestinal bleed who presented to our endoscopy centre from January 2010 to December 2019 was retrieved and analysed. The demographic data, clinical presentations and seasonal and monthly variation was analysed. Results: Out of a total of 10200 patients presenting with upper gastrointestinal bleed during the study time period, 530 patients had a diagnosis of variceal bleed after esophagogastroduodenoscopy (EGD). The majority of variceal bleed patients (48.5%) were seen between May to August months of the year. Conclusions: Contrary to the most of the literature which shows increased frequency of variceal bleed during winters, our patients bleed more during the months of May and August. This could be explained on the basis of unique socio-cultural and demographic pattern of this part of the world.

scholarly journals Gastric Protection and Gastrointestinal Bleeding with Aspirin Thromboprophylaxis in Hip and Knee Joint Replacements

2008 ◽  
Vol 90 (4) ◽  
pp. 332-335 ◽  
Author(s):  
TR Madhusudhan ◽  
A Rangan ◽  
PJ Gregg
Keyword(s):  
Knee Arthroplasty ◽  
University Hospital ◽  
Peptic Ulcers ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Hip And Knee Arthroplasty ◽  
Group 2 ◽  
Gi Bleed ◽  
Group 1

INTRODUCTION Upper gastrointestinal (GI) bleeding in patients who undergo hip and knee arthroplasty tends to be associated with non-steroidal anti-inflammatory drug use, steroid intake, pre-existing peptic ulcers and smoking. The use of aspirin for thromboprophylaxis is an added risk for the occurrence of GI bleed. The aim of this study was to determine the incidence of upper GI bleeding and whether the use of peri-operative oral ranitidine reduces the incidence of upper GI bleeding when aspirin thromboprophylaxis is used for hip and knee arthroplasty. PATIENTS AND METHODS Data from 1491 and 886 patients who underwent hip and knee replacements at the James Cook University Hospital (group 1) and at Friarage Hospital, Northallerton (group 2), respectively, were analysed in retrospect. All patients received 150 mg of aspirin per day for a period of 6 weeks from the day of surgery. Additionally, patients operated at the Friarage Hospital received 300 mg of oral ranitidine per day, for three postoperative days. RESULTS We observed that patients in group 1 had a higher incidence of overt upper GI haemorrhage, which was statistically significant (P <0.014) compared to patients in group 2. CONCLUSIONS Based on this experience, we recommend the use of peri-operative gastric protection with ranitidine when aspirin is used for thromboprophylaxis in hip and knee arthroplasty.

scholarly journals ETIOLOGICAL PROFILE OF LOWER GASTROINTESTINAL BLEED IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

2019 ◽  
pp. 1-2
Author(s):  
Bansal Arpit
Keyword(s):  
Dietary Habits ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Smoking History ◽  
Care Hospital ◽  
Gi Bleeding ◽  
Study Results ◽  
Lower Gi Bleeding ◽  
History Of ◽  
Gi Bleed

NTRODUCTION - Lower Gastrointestinal(GI) bleeding refers to blood loss of recent onset originating from a site distal to the ligament of Treitz.1It usually presents as hematochezia i.e. passage of maroon or bright red blood or blood clots per rectum. Lower GI bleeding ( LGIB) accounts for almost 20% of all cases of acute GI bleeding.2 The etiology and the epidemiology of LGIB varies according to the environmental conditions depending upon the life style, dietary habits, the prevalence of smoking, history of drug intake, age and longevity of the population etc.2 Most of the studies pertaining to the etiologies of Lower GI bleeding are from the West. Data relating to the incidence and etiologies of Lower GI bleed in India is scarce hence this study was undertaken to identify the etiological profile of patients presenting with Lower GI bleeding in a tertiary care hospital in the northern part of India. MATERIALS AND METHODS - It is a Cross-sectional study done over a period of 1 year from January, 2018 to December, 2018. All the patients above 18 years of age with first presentation of Lower GI bleeding to the Department of Medicine, SRMS- IMS, Bareilly, Uttar Pradesh during the period of study are included in the study. RESULTS - A total of 232 patients meeting the inclusion criteria were included in the study. Majority of the patients were males (69.8%). Hematochezia (86%) was the most common presenting feature and was commonly associated with constipation (46%), abdominal pain (32%) and loss of weight (11%). 8% of the patients had a history of Diabetes. Alcohol consumption was seen in 17% of the patients while 26% of the patients had a history of smoking. The most common etiology of Lower GI bleed seen was Hemorrhoids (35.3%), followed by Inflammatory Bowel disease(16.3%), Malignancy(12%) and Radiation proctosigmoiditis (11.2%). CONCLUSION - LGIB is a common and alarming presenting condition in the practice of gastroenterology. It was found that Lower GI bleed is more common in males, usually in the 3rd to 4th decade of life and most commonly presents with hematochezia. Haemorrhoids, IBD and Malignancy were the major causes of Lower GI bleed.

scholarly journals Efficacy of Octreotide Versus Terlipressin along with Endoscopic Variceal Ligation (EVL) in Preventing Re-bleeding and Mortality in Acute Bleeding Esophageal Varices in Cirrhosis: A Randomized Prospective Study

2021 ◽  
pp. 95-102
Author(s):  
Sunayana Lomte ◽  
Sourya Acharya ◽  
Vijendra Kirnake
Keyword(s):  
Prospective Study ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Bleeding Esophageal Varices ◽  
Variceal Bleed ◽  
Significant Difference

Background: Octreotide and terlipressin are two pharmacologic drugs used as an adjuvant therapy in the treatment of acute esophageal variceal bleeding. Large enough clinical trial data is not available, in comparing the efficacy of octreotide versus terlipressin as an adjunct to EVL for control of variceal bleed. Still, there is a scarcity of data on which is the better efficient drug amongst terlipress in and octreotide to control 5 days rebleeding. Aim: To compare efficacy of octreotide versus terlipressin in preventing the 6 weeks mortality (primary outcome) and 5 days rebleeding (secondary outcome) in cases of acute esophageal variceal bleeding. Method: All the patients of cirrhosis of liver presenting with upper gastrointestinal bleeding admitted in the Medicine Intensive Care Unit(MICU) at Acharya Vinoba Bhave Rural Hospital (AVBRH) will be enrolled. In this Randomized Prospective study ,patients presenting with acute esophageal variceal bleed, after diagnostic endoscopy during a period of one year (august 2020 to july 2021) will be randomised into two group by simple randomisation with chits: Group A will receive Terlipressin while Group B will receive Octreotide for 5 days combined with esophageal variceal ligation. These two groups will be compared in terms of hemodynamic effects, child pugh score, MELD (Model for End stage Liver Disease) score to predict 6 weeks mortality as primary outcome and 5 day treatment failure as secondary outcome according to Bavino VI consensus statement. Expected results: From our study we are anticipating that both octreotide and terlipressin will be equally efficacious in controlling the EVB when given along with EVL therapy and also there will be no difference in both the drugs in preventing 6 weeks mortality and 5 days rebleeding. Conclusion: There will be no significant difference between Terlipressin and Octreotide in preventing 6 week mortality and 5 day rebleeding in bleeding esophageal varices when given along with EVL therapy.

MORTALITY ASSOCIATED WITH VARICEAL BLEED IN CIRRHOSIS PATIENTS ATTENDING A TERTIARY CARE CENTRE IN SOUTH KERALA.

2021 ◽  
pp. 42-44
Author(s):  
Joshi S.C. ◽  
Godawari Joshi ◽  
Nair A.K. ◽  
Khiangate Banjamin ◽  
Raviraj Sunil
Keyword(s):  
Variceal Bleeding ◽  
Bleeding Episode ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Recurrent Bleeding ◽  
High Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Acute Variceal Bleeding ◽  
Variceal Bleed

Background : Acute variceal bleeding is a most common complication of portal hypertension. Despite advancement in management of variceal bleeding still carries a very high morbidity and mortality. The present study was undertaken to study mortality associated with variceal bleed in cirrhotic patients attending a tertiary care hospital. Method : This prospective study was conducted between June 2016 to may 2018. Total 60 patients included in the study who admitted with acute variceal bleeding episode with underlying cirrhosis. Results : Majority of patients were male ( 76 %). The mean age of patients was 54 +/- 13.7. Most common etiology of cirrhosis was Alcohol related liver disease (51.7% ). Most common presenting symptom was hematemesis with melena(41.7%). Majority of patients presented with recurrent bleeding episodes (61.7% ). 18.3% Patients had rebleeding episode within 5 days of admission. Total 21 (35 % ) patients died during study period. Univariate analysis showed advance age, presence of ascites, Encephalopathy, high creatinine, bilirubin and INR were important predictors of mortality. In multivariate analysis only signicant predictors was serum creatinine (OR 43.1 (CL3.05 to 608.64)). Conclusion: Patients with cirrhosis are always at risk of variceal bleeding. The survival after a bleeding episode was inuenced by age, comorbidities, in hospital complications, ascites, high CTPand MELD score , beta blocker therapy

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