Aetiology and Management Outcome of Upper Gastrointestinal Bleeding in Adult Patients Presenting at Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria

Ajayi, Akande Oladimeji; Adegun, Patrick Temi; Ajayi, Ebenezer Adekunle; Solomon, Oluremi Olayinka; Adeoti, Adekunle Olatayo; Akolawole, Michael

doi:10.15580/gjms.2013.3.021513463

Cited by 8 publications

(13 citation statements)

References 19 publications

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“…It is also a known fact that mucosal lesions heal quickly and generally the time interval between the bleeding episode and endoscopy can influence the endoscopic diagnosis. The male preponderance in patients that presented with UGIB that was observed in this study was similar to studies by Olokoba et al in Ilorin [12] and Ajayi et al in Ekiti [31].…”

Section: Discussionsupporting

confidence: 92%

“…Bleeding was obscured in 19% of patients with UGIB. This figure was much higher compared to other studies [22,31,32].The reasons for this may include late presentation to seek healthcare especially in a low income poor resource settings after onset of symptoms, poor accessibility to endoscopic facilities and personnel, and most patients pay-out-of-pocket to access medical care in Nigeria. It is also a known fact that mucosal lesions heal quickly and generally the time interval between the bleeding episode and endoscopy can influence the endoscopic diagnosis.…”

Section: Discussionmentioning

confidence: 61%

“…Hiatus hernia presents with UGI symptoms but majority may be asymptomatic especially when anatomically small. Studies in Nigeria report a prevalence range of between 3.3-28%- [31,36] in Nigerians. A recent study in the Niger-Delta region of Nigeria showed a prevalence rate of 20.1% [37], while another European study quoted 21.2%) [38].…”

Section: Discussionmentioning

confidence: 99%

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Indications and findings in patients referred for endoscopy in a private health centre in Sokoto, Northwestern Nigeria

Sadiq¹,

Jibril²

2020

World J. Adv. Res. Rev.

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Upper gastrointestinal tract symptoms are associated with a major morbidity and mortality globally. Endoscopy offers direct visualization of the pathology and enables both diagnostic and therapeutic interventions. Request for the procedure is on the increase probably due to exposure to more risk factors or because of increased awareness about the disease. We aimed to study the indications and findings in patients referred for endoscopy. We enrolled a total of 1747 patients between January 2013-December 2019.Their demographic characteristics and findings on endoscopy were extracted from the endoscopy register. Males constituted 937 (53.7%), with a mean age of 42.50 ± 14.13 and females 41.38 ± 16.73. The age range of patients was 15-87 years. The commonest indication was dyspepsia 1122(64.2%).There was no significant statistical difference between gender with respect to dyspepsia (ꭓ2= 0.8511 pvalue = 0.3563. Upper gastro-intestinal bleeding (UGIB) was the second most common 10.3%, Gastroesophageal reflux disease (GERD) 9.9%, and chronic liver disease (CLD) 8.0%.There was significant statistical difference in gender presentation of UGIB ( ꭓ2= 6.49 p-value= 0.0109 and CLD ꭓ2= 21.109 p-value= 0.00001).Gastritis was the predominant endoscopic finding, 628(35.9%). Esophageal varices were the c ommonest etiologic finding for UGIB (51.6%) and commoner in males (ꭓ2= 11.083 p-value= 0.0009), then gastric and duodenal ulcers, 11.4% and 2.7% respectively. Hiatus hernia was 157(9.0%) Upper gastrointestinal malignancies were 2.4%. In conclusion, dyspepsia is a common clinical presentation in patients with GIT symptoms. Variceal bleeding is a significant cause of UGIB, therefore early endoscopic CLD screening will help reduce morbidity and mortality in Nigeria.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 61%

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Indications and findings in patients referred for endoscopy in a private health centre in Sokoto, Northwestern Nigeria

Sadiq¹,

Jibril²

2020

World J. Adv. Res. Rev.

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“…Furthermore, in our study, gastritis accounted for the third-most common cause of UGIB. It should be noted that Ajayi et al reported that gastritis was the most common cause of UGIB in their case study from southwest Nigeria [ 34 ]. Most of our patients were either farmers, artisans or traders.…”

Section: Discussionmentioning

confidence: 99%

Management of overt upper gastrointestinal bleeding in a low resource setting: a real world report from Nigeria

et al. 2014

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BackgroundUpper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide that has significant associated morbidity, mortality, and health care resource use. This study outlines the aetiology, clinical presentation, and treatment outcomes of patients with UGIB in a Nigerian low resource health facility.MethodsThis was a descriptive study of consecutive patients who underwent upper gastrointestinal (GI) endoscopy for upper GI bleeding in the endoscopy unit of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria from January 2007 to December 2013.ResultsDuring the study period, 287 (12.4%) of 2,320 patients who underwent upper GI endoscopies had UGIB. Of these, 206 (72.0%) patients were males and their ages ranged from 3 to 100 years with a median age of 49 years. The main clinical presentation included passage of melaena stool in 268 (93.4%) of individuals, 173 (60.3%) had haematemesis, 110 (38.3%) had haematochezia, and 161 (56.1%) were dizzy at presentation. Observed in 88 (30.6%) of UGIB patients, duodenal ulcer was the most common cause, followed by varices [52 (18.1%)] and gastritis [51 (17.1%)]. For variceal bleeding, 15 (28.8%) and 21 (40.4%) of patients had injection sclerotherapy and variceal band ligation, respectively. The overall rebleeding rate for endoscopic therapy for varices was 16.7%. For patients with ulcers, only 42 of 55 who had Forrest grade Ia to IIb ulcers were offered endoscopic therapy. Endoscopic therapy was áin 90.5% of the cases. No rebleeding followed endoscopic therapy for the ulcers. The obtained Rockall scores ranged from 2 to 10 and the median was 5.0. Of all patients, 92.7% had medium or high risk scores. An increase in Rockall score was significantly associated with length of hospital stay and mortality (p < 0.001). The overall mortality rate was 5.9% (17 patients).ConclusionEndoscopic therapy for UGIB in a resource-poor setting such as Nigeria is feasible, significantly reduces morbidity and mortality, and is cost effective. Efforts should be made to improve the accessibility of these therapeutic procedure for patients with UGIB in Nigeria.

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“…Upper gastrointestinal bleeding is traditionally defined as bleeding from the gastrointestinal tract that is proximal to the ligament of Treitz [13]. Risk factors include use of NSAIDs, aspirin, alcohol consumption, cigarette smoking, acid peptic disorders and chronic liver disease among others [13][14][15]. Upper gastrointestinal bleeding is a potentially fatal condition with a mortality rate of 6%-13% in the literature despite advances in critical care monitoring and support [16].…”

Section: Discussionmentioning

confidence: 99%

An 8-year retrospective review of gastrointestinal medical emergency conditions at a tertiary health facility in Nigeria

Oluwagbenga¹,

Musah²

2018

SJMS

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Background: Globally, gastrointestinal emergency conditions constitute a considerable proportion of the medical emergency cases seen in the emergency room.Objective: This study investigated the spectrum of gastrointestinal medical emergency conditions seen in the emergency room of Federal Teaching Hospital Ido-Ekiti, Nigeria. Materials and Methods:The emergency room admission register was used to obtain the following information: Age, Sex, Diagnosis, Year of admission and the Outcome.The period under review was 1st January 2009 to 31st December 2016. The data was analyzed using the SPSS version 21.0 software package.Results: A total number of 5,912 patients with medical emergency conditions were admitted into the emergency room during the period under review, out of which 813(13.7%) were gastrointestinal medical emergency conditions. The age range of the patients was 15 to 100years with a mean(±SD) of 47.32±18.938. Acute exacerbation of acid peptic disorders(29.3%) was the most common indication for emergency room admission followed by acute gastroenteritis(26.8%) and decompensated chronic liver disease(14.3%). Decompensated chronic liver disease and upper gastrointestinal bleeding were the conditions with the highest mortality being 31.8% and 29.5% respectively. Conclusion:Gastrointestinal medical conditions are common indications for emergency admission. Measures should be taken to avoid these preventable conditions in a bid to reduce their morbidity and mortality.

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Aetiology and Management Outcome of Upper Gastrointestinal Bleeding in Adult Patients Presenting at Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria

Cited by 8 publications

References 19 publications

Indications and findings in patients referred for endoscopy in a private health centre in Sokoto, Northwestern Nigeria

Indications and findings in patients referred for endoscopy in a private health centre in Sokoto, Northwestern Nigeria

Management of overt upper gastrointestinal bleeding in a low resource setting: a real world report from Nigeria

An 8-year retrospective review of gastrointestinal medical emergency conditions at a tertiary health facility in Nigeria

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