scholarly journals Early Endoscopic Findings in Patients with Upper Gastrointestinal Bleeding in Bangladesh

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

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

2014 ◽  
Vol 05 (04) ◽  
pp. 139-143 ◽  
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.

scholarly journals Spectrum of Endoscopic Findings in Patients of Upper Gastrointestinal Bleeding at a Tertiary Care Hospital

Cureus ◽  
2019 ◽  
Author(s):  
Waseem Sarwar Malghani ◽  
Romaisa Malik ◽  
Farooq Mohyud Din Chaudhary ◽  
Asim Tameez Ud Din ◽  
Misbah Shahid ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

scholarly journals Pattern of drug-induced bleeding in a tertiary care hospital

2017 ◽  
Vol 5 (4) ◽  
pp. 1198 ◽  
Author(s):  
Rajinder Negi ◽  
Rajesh Kashyap ◽  
Anupam Prashar ◽  
Brij Sharma ◽  
Sanjeev Asotra ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Categorical Variables ◽  
P Value ◽  
Severe Bleeding ◽  
Care Hospital ◽  
Drug Induced ◽  
Upper Gastrointestinal

Background: It is a well-known fact that drug-induced bleeding causes considerable morbidity and mortality. Drugs that induce bleeding do so by affecting either anti-platelet Function and /or coagulation. By the frequency of their use, anti-platelet, a coagulant, thrombolytic and NSAIDs are the most commonly implicated drugs. Upper gastrointestinal bleeding is commonest adverse drug reaction associated with hospital admission. Significant number of these could be prevented if simple guidelines are followed. Spontaneous cessation of bleeding occurs in as many as 85% of cases. Early intervention is required in those if bleeding does not stop spontaneously. Objective of the study was to determine the pattern of drug induced bleeding in tertiary care hospital setting.Methods: It was a hospital based observational study conducted during one year study dura on ((June 1, 2014 to May 31, 2015) amongst all adult patients admitted to the hospital with drug induced bleeding. Statistical analysis was done by frequency measurement for categorical variables. Chi- square test was used to determine associations. A p-value of<0.05 was taken as statistically significant.Results: A total number of 110 cases with history of bleeding were enrolled. Commonest drug that caused bleeding was a platelet with 29 (26%) cases followed by combination of 2 or more drugs in 25 (23%) cases, then NSAIDs and anticoagulants in 24 (21%) and 23 (20%) cases respectively. Upper gastrointestinal bleeding was the commonest site of bleeding seen in 64 (58%) cases. The commonest drugs causing upper GI bleeding were NSAIDs seen in 24 (37.5%) cases followed by a platelet 22 (34.3%), combined drugs in 09 (14%) cases. (P<0.001) In overall severity most cases of drug induced bleeding had mild bleeding with 61 cases as compared to 38 cases of moderate and 11 cases of severe bleeding. There were significantly higher proportion of mild and moderate bleeding in upper gastrointestinal bleed cases in comparison to other sites of drug induced bleeding in this study (p<0.01). 7 (6.4%) out of 110 patients died and 103 (93.6%) patients recovered and were discharged.Conclusions: Clinical management of bleeds requires careful assessment of the patient, haemodynamic stabilisation, discontinuation of the offending medication and, where appropriate, reversal of the haemorrhagic effects and specific therapies such as endoscopic haemostatic therapy.

scholarly journals Gastroduodenal Perforation and Ulcer Associated With Rotavirus and Norovirus Infections in Japanese Children: A Case Report and Comprehensive Literature Review

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Norishi Ueda
Keyword(s):  
Risk Factors ◽  
Duodenal Ulcer ◽  
Metabolic Acidosis ◽  
Literature Review ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Common Symptom ◽  
Female Ratio ◽  
Gastroduodenal Perforation ◽  
Upper Gastrointestinal

Abstract Background.  There is no literature review on gastroduodenal perforation or ulcer (GDPU) with rotavirus (RV) and norovirus (NoV) gastroenteritis. Methods.  Pediatric cases of GDPU or upper gastrointestinal bleeding with RV and NoV gastroenteritis were searched from September 1974 until October 2015 using PubMed, Google for English, other-language-publications, and Ichushi (http://www.jamas.or.jp) for Japanese-language publications. All reports confirming GDPU or upper gastrointestinal bleeding with RV and NoV gastroenteritis were eligible for inclusion in the study. In addition, clinical characteristics were reviewed. Results.  A boy with duodenal ulcer (DU) and NoV gastroenteritis was described. There were 32 GDPU cases (23 RVs and 9 NoVs cases), including our case; with the exception of 1 case, all were Japanese. Mean age, male/female ratio, and symptoms' duration before admission were 21.6 months, 2.2, and 4.0 days, respectively. Vomiting was the most common symptom, followed by diarrhea, lethargy, fever, abdominal distension, and convulsion. Dehydration, hematemesis, melena, drowsiness or unconsciousness, shock, metabolic acidosis, leukocytosis, anemia, positive C-reactive protein, high blood urea nitrogen, and hyponatremia commonly occurred. Helicobacter pylori was a minor cause of GDPU. Duodenal (DP) or gastric perforation (GP) developed in 14 cases (10 DP/RVs, 1 GP/RV, and 3 DP/NoVs). Duodenal ulcer or gastric ulcer (GU) developed in 18 cases (10 DU/RVs, 4 DU/NoVs, 1 GU/RV, 1 GU + DU/NoV, and 2 upper gastrointestinal bleeding/RVs). The predominant perforation or ulcer site was in the duodenum. With the exception of 2 deaths from DU, all cases recovered. Conclusions.  Race, young age, male, severe dehydration, metabolic acidosis, drowsiness and unconsciousness, and shock may be potential risk factors of GDPU associated with RV and NoV gastroenteritis. Limitation of this descriptive study warrants further investigations to determine the risk factors in these infections that could be associated with GDPU.

scholarly journals MP15: Blood transfusion in upper gastrointestinal bleeding: evaluating physician practices in the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S47
Author(s):  
J. Stach ◽  
S. Sandha ◽  
M. Bullard ◽  
B. Halloran ◽  
H. Blain ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Care ◽  
Blood Transfusions ◽  
Care Hospital ◽  
Current Guideline ◽  
Transfusion Threshold ◽  
Physician Practices ◽  
Upper Gastrointestinal

Introduction: Acute upper gastrointestinal bleeding (UGIB) is a common presentation to emergency departments (ED). Of these patients, 35-45% receive a blood transfusion. Guidelines for blood transfusion in UGIB have been well established, and recommend a hemoglobin (Hb) level below 70 g/L as the transfusion target in a stable patient. There is no consensus on a transfusion threshold for unstable UGIB. There is limited data regarding physician practices in the ED. The aim of our study is to determine the appropriateness, by expert consensus, of blood transfusions in UGIB in a tertiary care hospital ED. Methods: We retrospectively reviewed patients presenting with UGIB to the University of Alberta Hospital ED in 2016. These patients were then screened for blood transfusions. Data were obtained from the patient records. Chart derived data were verified with records obtained from the blood bank. For each patient, the history, vitals, Glasgow Blatchford Score (GBS), relevant labs, and record of blood transfusions were collected and organized into a case summary. Each patient summary was presented individually to a panel of three expert clinicians (2 Gastroenterology, 1 Emergency Medicine), who then decided on the appropriateness of each blood transfusion by consensus. Results: Blood transfusions (data available 395/400) were given to 51% (202/395) of patients presenting with UGIB. Of these, 86% (174/202) were judged to be appropriate. Of the 395 patients, 34% (135/395) had a Hb of &lt;70 g/L. Of these, 93% (126/135) were transfused, and all of these were considered appropriate. 18% (70/395) had a Hb between 71-80. 74% (52/70) of these patients were given blood, and 79% (41/52) were considered appropriate. 13% (50/395) of the patients had a Hb between 81-90, with 28% (14/50) receiving a transfusion. Of these, 36% (5/14) were deemed to be appropriate. 35% (140/395) of patients had a Hb of &gt;90. 7% (10/140) of these received blood. 20% (2/10) were considered appropriate. Conclusion: The panel of expert clinicians judged 86% of the blood transfusions to be appropriate. All transfusions under the recommended guideline of 70 g/L were considered appropriate. In addition, the majority of transfusions above a Hb of 70 g/L were considered appropriate, but 37% were not. Further studies evaluating the feasibility of current guideline recommendations in an ED setting are required. Educational interventions should be created to reduce inappropriate blood transfusions above a Hb 70 g/L.

Study of Endoscopic Findings in First Episode of Upper Gastrointestinal Bleeding

2021 ◽  
Vol 10 (1) ◽  
pp. 14-19
Author(s):  
Krishna Raj Adhikari ◽  
Rajesh Kumar Mandal
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
First Episode ◽  
Gastric Erosion ◽  
Ulcer Disease ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

Background and Aims: Upper gastrointestinal bleeding (UGIB) is one of the most common and grave emergencies encountered in Emergency department in Tertiary health care centre in our country. Upper endoscopy has a crucial role in the diagnosis and treatment of upper gastrointestinal bleeding. The aim of this study is to assess the endoscopic findings in patients presenting with first episode of UGIB. Methods: This was a hospital based cross sectional study of patients with haematemesis, melena or both who underwent UGI endoscopy at Bir Hospital during January 2019 to January 2020. Patient demographics, site and nature of lesions and risk factors for bleeding were analyzed. Results: Among 72 enrolled patients 48 (66.67 %) were male and 24 (33.3 %) were female. Haematemesis 27% was the most common presenting complain followed by melena 25.5% and fainting/ dizziness 22.5%. Endoscopy was done in all cases and gastric ulcer disease 27.8% was the commonest cause of first episode of UGI bleeding followed by variceal bleeding, gastric erosion and duodenal ulcer, 25%, 16.7%, 12.5% respectively. Conclusions: Peptic ulcer disease was the most common cause of first episode of UGI bleeding in our context. Among peptic ulcer diseases gastric ulcer was more common than duodenal ulcer. Haematemesis and melena were the commonest clinical presentation of UGI bleeding.  

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