Study of Endoscopic Findings in First Episode of Upper Gastrointestinal Bleeding

Abstract

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.

Comparative Study of Clinical Profile and Outcome Among Variceal and Nonvariceal Bleeding in a Tertiary Referral Hospital of Nepal During Covid Pandemic

“…Our studies showed almost half the proportion (47.06%) of upper GI bleeding is from variceal sources. Previous studies done in Nepal had shown a lesser prevalence that is 25 % in a study by Adhikari KR et al 8 and 23% in a study by Poudel MS et al 9 . The changing prevalence may reflect the different scenarios of the COVID lockdown period where the patients with minor GI bleeding may have been treated in the local primary health centre and only those with a large amount of bleeding or with co-morbidities referred to the tertiary health care centre like ours.…”

“…The mean age of the participants and the proportion of males were comparable with the other studies done previously in Nepal. [8][9][10] Among clinical parameters, the presence of jaundice, ascites, An accurate prediction of the cause of upper GI bleeding before the endoscopy procedure is important in a country like Nepal where there are few endotherapy centers besides a few major cities. This prior knowledge will enable clinicians to choose the most appropriate pharmacological therapy before performing the procedure or transferring to the higher facility center.…”