A Study of Clinical and Endoscopic Profile of Acute Upper Gastrointestinal Bleeding

Dewan, Khus Raj; Patowary, Bhanumati Saikia; Bhattarai, Subash

doi:10.3126/kumj.v12i1.13628

Cited by 25 publications

(30 citation statements)

References 13 publications

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“…The mean age in this study in patients presenting with UGIB was 47.87±16.16years, which was comparable to several past studies. 5 11.92% UGIB patients had a normal endoscopy in this study, which was similar to 13.9% of Cotton PB et al 12 Most UGIB patients in this study presented with hematemesis with malena, followed by hematemesis, similar pattern has also been reported by Dewan KR et al 13 More than half (52.94%) of the UGIB cases were attributed to portal hypertension i.e. esophageal or gastric variceal bleed.…”

Section: Discussionsupporting

confidence: 87%

“…7,8 Erosive Gastroduodenitis, was the third commonest cause of UGIB (12.28%), which was similar to that suggested by recent work by Dewan KR et al, (11%) but significantly higher than 9% as suggested in some older Indian studies. 7,8,13 This may be attributed to changing lifestyle pattern, diet, frequent use of alcohol and over the counter NSAIDS.…”

Section: Discussionmentioning

confidence: 99%

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Study of clinical and endoscopic profile of dyspepsia and upper gastrointestinal bleed

et al. 2019

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Background: Upper gastrointestinal bleed (UGIB) and dyspepsia are the commonest indications for an upper GI endoscopy (UGIE), which has the potential to provide both diagnostic and therapeutic intervention. Alarm symptoms in patients with dyspepsia need proper evaluation.Methods: In an observational hospital-based study, 5117 patient undergoing upper GI endoscopy were evaluated at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India. Detailed clinical and endoscopic profile was evaluated for subjects with dyspepsia and UGIB. Statistical analysis was done using SPSS version 21.0.Results: Dyspepsia (2887, 56.41%) followed by upper GI bleed (1124, 21.97%) were the most common indications for UGIE. In subjects presenting with UGIB, most patients had both hematemesis with Malena (48.04%), 48.93% were chronic alcoholics and nearly one fourth (26.96%) were on NSAIDS. Variceal bleeding (52.94%), followed by peptic ulcer bleed (13.43%) were the most common causes of bleed. In subjects undergoing UGIE for dyspepsia, 37.41% revealed no endoscopic lesion followed by gastro-duodenitis (25.01%). Peptic ulcer was cause of dyspepsia in 18.05% and was significantly more in those with alarm symptoms (<0.001). Alarm symptoms in dyspepsia has a significant high likelihood of finding a malignant lesion on endoscopic evaluation (p 0.013).Conclusions: Variceal bleed is the most common cause of UGIB in the adult Indian population. In patients with dyspepsia, presence of alarm symptoms is significantly associated with organic lesion on endoscopy. Although the incidence of malignancy is low, endoscopy in more than 50years subjects presenting with dyspepsia may help in early diagnosis and reducing morbidity.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Study of clinical and endoscopic profile of dyspepsia and upper gastrointestinal bleed

et al. 2019

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“…Another study from Pakistan, Islamabad concluded that variceal bleeding is a common cause of UGIB in Pakistan. 14 Both the studies of Pakistan which is quoted in this study commented upon high prevalence of cirrhosis due to hepatitis leading to varices as a cause of UGIB. In our study variceal bleeding was the most important cause however unlike both these studies from Pakistan, alcoholic cirrhosis was the most common cause of varices, while they reported that hepatitis is the common cause for the cirrhosis.…”

Section: Discussionmentioning

confidence: 77%

“…Similar prevalence studies are done in India as well as from other developing countries. [9][10][11][12][13][14][15][16][17] As studies are from different geographical locations and having different infrastructural facilities, results in relation to causes, clinical profile and outcome may vary. Table no 6 shows analysis of different studies having almost similar objectives of their research.…”

Section: Discussionmentioning

confidence: 99%

Study of Aetiology, Clinical Profile and Endoscopic Findings of Patients With Upper Gastrointestinal Bleeding- A Study From Rural Base Multispecialty Teaching Hospital

Kumar¹,

Lakhani²,

Shah³

et al. 2019

jebmh

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BACKGROUNDUpper gastrointestinal bleeding (UGIB) is one of the common life-threatening emergency hospital admissions. Upper GI Endoscopy is one of the common diagnostic examinations for identifying the cause of bleeding in our as well as in resourcelimited setup which ultimately help a clinician for "resource-sensitive approach". METHODSThis observational study (2015)(2016)(2017) of upper gastrointestinal bleeding (UGIB) was performed at rural based multispecialty teaching hospital in consecutive 115 adult admitted patients (age>12 years) to find out aetiology and clinical as well as esophagogastroduodenoscopic profile. RESULTSOf 115 patients of UGIB, 75 were male (65.21%) and 40 female (34.78%). Mean age was 42.06 ±16.31. 77 (66.95%) presented with hematemesis, 21 (18.26%) with melena, 16 (13.91%) with hematemesis combined with melena and 1 patient presented with hematemesis as well as haematochezia. Endoscopy was able to detect definite cause of UGIB in 104 and in 11 patients it was normal (90.43%). Variceal bleed was commonest and was present in 48 patients, of whom 44 patients (38.26%) had oesophageal, 02 had gastric and other 2 had both oesophageal as well as gastric varices. In non-variceal bleeding, gastric and duodenal ulcer disease was present in 12, esophagitis in 10, oesophageal vascular ectasia in 02, erosive gastritis in 17, gastric malignancy in 04; Mallory Weiss tear in 06, erosive gastritis with duodenitis in 04, and esophagitis with gastric ulcer and duodenal ulcer in 01. 10 of 17 patients who had erosive gastritis gave history of NSAID use. Of the 48 patients who had variceal bleeding, 33 were due to cirrhosis of liver, and 15 were because of non-cirrhotic portal hypertension. Aetiology of 33 patients, who had hospital admission due to cirrhosis of liver related UGIB, was alcohol, hepatitis B, and hepatitis C in 29, 2 and 1 patients respectively. 81 (70.43%) had acute bleeding while 34 (29.56%) had recurrent bleeding. 17 patients were admitted in 2015, 45 in 2016 and 53 in 2017 for UGIB. There was no seasonal variation in incidence of UGIB.

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“…[2][3][4] The prevalence of esophageal varices in LC is around 80%-90% 5,6 and variceal hemorrhage occurs at a rate of 10%-30% yearly. 7 Two studies from Nepal have shown esophageal varices as the cause of upper GI bleeding in 47.5% 8 and 15.6% 9 cases respectively.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Endoscopic Variceal Band Ligation

Shrestha

Chaudhary

et al. 2017

J Nepal Med Assoc

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Introduction: Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices.Methods: This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017. Consecutive cases who presented in emergency room with acute variceal bleeding due to liver cirrhosis and cases of liver cirrhosis with large varices and red color signs on endoscopic examination were enrolled. They underwent EVL and subsequent re-endoscope at one month interval till the eradication of varices was achieved. Results: Among 83 patients, 15 (18.1%) were of Child Pugh class A, 29 (34.9%) B and 39 (47%) were of C. In 20 (24.1%) cases varices could be eradicated in one session of EVL while 57 (68.7%) required two sessions and in 6 (7.2%) cases it took three sessions. Total average EVL session required for obliteration of esophageal varices was 1.84±0.53. There was only one (1.2%) of early re-bleeding post EVL.Conclusions: EVL is an effective modality of treatment in controlling acute esophageal variceal bleeding, in preventing future variceal bleeding as well as in eradicating esophageal varices, with very few complications.Keywords: acute variceal bleeding; cirrhosis; endoscopic variceal ligation; large varices; red color sign. [PubMed]

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A Study of Clinical and Endoscopic Profile of Acute Upper Gastrointestinal Bleeding

Cited by 25 publications

References 13 publications

Study of clinical and endoscopic profile of dyspepsia and upper gastrointestinal bleed

Study of clinical and endoscopic profile of dyspepsia and upper gastrointestinal bleed

Study of Aetiology, Clinical Profile and Endoscopic Findings of Patients With Upper Gastrointestinal Bleeding- A Study From Rural Base Multispecialty Teaching Hospital

Outcome of Endoscopic Variceal Band Ligation

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