Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records

Abstract

-Background -Upper gastrointestinal bleeding is a frequent and potentially severe complication of most digestive diseases of the upper gastrointestinal tract. Upper endoscopy has a crucial role in the diagnosis and treatment of upper gastrointestinal bleeding, however epidemiological studies are still limited in our country. Aims -To assess the clinical characteristics, endoscopic accuracy, treatment efficiency and clinical outcome of patients admitted to the endoscopic unit with upper gastrointestinal bleeding. Methods -A retrospective study of consecutive records from patients who underwent emergency endoscopy for upper gastrointestinal bleeding was performed during a period of 2 years. Results -Most patients were male 68.7%, with a mean age of 54.5 ± 17.5 years. A bleeding site could be detected in 75.6% of the patients. Diagnostic accuracy was greater within the first 24 hours of the bleeding onset, and in the presence of hematemesis. Peptic ulcer was the main cause of upper gastrointestinal bleeding (35%). The prevalence of variceal bleeding (20.45%) indicates a high rate of underlying liver disease. Endoscopic treatment was performed in 23.86% of the patients. Permanent hemostasis was achieved in 86% of the patients at the first endoscopic intervention, and in 62.5% of the patients after rebleeding. Emergency surgery was seldom necessary. The average number of blood units was 1.44 ± 1.99 per patient. The average length of hospital stay was 7.71 ± 12.2 days. Rebleeding was reported in 9.1% of the patients. The overall mortality rate of 15.34% was significantly correlated with previous liver disease. Conclusions -Diagnostic accuracy was related to the time interval between the bleeding episode and endoscopy, and to clinical presentation. Endoscopic therapy was an effective tool for selected patients. The resulting increased duration of hospitalization and higher mortality rate in the patients submitted to therapeutic endoscopy were attributed to a higher prevalence of variceal bleeding and underlying liver disease.

Association of intestinal helminths and P. falciparum infections in co-infected school children in northwest Tanzania

“…This result is similar to that reported in other studies (Rockall et al 1995;Vreeburg et al 1997;Zaltman et al 2002). The time interval between the bleeding episode and the endoscopic procedure are known to influence the accuracy and the likelihood of finding a cause endoscopically (Zaltman et al 2002).…”

Frequency of Upper Gastrointestinal Bleeding in Elderly Patients with Iron Deficiency Anaemia Presented at Liaquat University Hospital Jamshoro

“…In the light of above discussion my study results are like that of international and national data [14,[19][20][21][22][23][24][25].…”

“…Our study done at L.U.M.H.S Jamshoro observed as bleeding source in the duodenum in 36% patients mostly duodenal ulcers. A study done by foreign research workers at Brazil by Zaltmen [20] and other showed that bleeding source in the esophagus in 11% patients including esophageal erosions, Mallory Weiss syndrome etc., excluding varices [21].…”

“…They comprise peptic ulcer disease, erosive gastritis etc. A study done by Zaltman and Souza [20] and others research workers in 2002 showed bleeding source in the duodenum is 36% containing duodenal ulcer [20]. A study done by Palmer [21] who identified source of bleeding in the duodenum 32%.…”

Frequency, Determinants and Outcome of Upper Gastrointestinal Bleed among Patients with Liver Cirrhosis

“…In a study conducted by Katschinski et al 29 , death occurred in 189 (8.5%) patients, and 243 (11%) patients experienced rebleeding. Zaltmanet al 30 showed Rebleeding in 9.1% of the patients and overall mortality rate of 15.34%. In study conducted by D'Amico et al 31 , 6-week rebleeding was 17%, and mortality was 20%.…”