Clinical Profile and Endoscopic Findings in Patients with Upper Gastrointestinal Bleed Attending a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Abstract

Introduction: Upper gastrointestinal bleeding is a common acute medical emergency. Endoscopyis the gold standard diagnostic and therapeutic tool in the management of upper gastrointestinalbleed. This study was undertaken to address the clinical profile, endoscopic profile, and outcomes inpatients with upper gastrointestinal bleed.
 Methods: A descriptive cross-sectional study was conducted in a tertiary care teaching hospital inGandaki Province, Nepal from January 2018 to December 2019 after obtaining ethical clearancefrom Institutional Review Committee (MEMG/IRC/291/GA) and informed consent fromthe patient or patient relatives. The sample size was calculated. Six hundred and sixty patientswith upper gastrointestinal bleed were included in the study. Data entry was done in StatisticalPackages for the Social Sciences version 20.
 Results: Peptic ulcers and ruptured oesophageal varices are the common aetiologies of uppergastrointestinal bleed. Inpatient mortality was seen in 98 (14.8 %) patients. Upper gastrointestinalbleed of variceal etiology presents with a higher Rockall score and has more chances of rebleedingand has higher mortality than those with non-variceal aetiologies. Bad prognostic factors wererebleeding, variceal etiology, and comorbidities including cirrhotic and Rockall score > 6.
 Conclusions: Upper gastrointestinal bleeding is a common acute medical emergency. Early uppergastrointestinal endoscopy preferably within 24 hours is recommended for diagnosis, timelyintervention, and management of the patients with an upper gastrointestinal bleed that helps inreducing morbidity and mortality.
 

Upper Gastrointestinal Bleeding among Patients Admitted in Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…Data from various studies conducted in Nepal showed that the mean age of patients was 49±12.64, 49±12.64, and 51.6 years, respectively, which are in line with our study. 6,9,10 However, a study displayed UGIB in the younger age group with the mean age being 45.32±18.47. 4 Manifestations of UGIB can be either obvious or hidden.…”

“… 10 However, other studies found peptic ulcer disease as common findings followed by variceal bleeding among patients with UGIB. 4 , 7 , 9 This may be due to difference in socio-economic and demographic difference between the local population where the study was conducted.…”

Incidence of Helicobacter pylori in patients with upper gastrointestinal symptoms: a hospital-based study

“…15 We found that there were 4 cases (2%) of stomach cancer in the present study and this finding is similar to the study done by Puttaraju et al 11 Bhattarai et al studied 660 patients with upper GI bleeding and found that peptic ulcer and ruptured esophageal varices were the most common causes. 16 14.8% of the patients died. Repeat bleeding episode, varices, and presence of comorbidities were important risk factors for death.…”

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“…The symptoms depend on both location and severity but may include bright red blood in vomit, cramps in the abdominal region, and shortness of breath. In the United States, over 100,000 people suffer from upper gastrointestinal bleeding, and men are twice as likely to have upper gastrointestinal bleeding [136]. One study showed the use of ingestible capsules to treat gastrointestinal hemorrhaging through balloon tamponade effect [137].…”