The Safety of Gastric Ulcer Biopsies and Random Gastric Biopsies in the Setting of an Overt Upper Gastrointestinal Bleed

Abstract

Background Acute upper gastrointestinal bleeding (UGIB) is a common cause of hospitalization, and esophagogastroduodenoscopy is the gold standard for diagnosis and therapy. Although cold forceps biopsies are considered a low bleeding risk, many defer gastric biopsies in the setting of UGIB. We aimed to conduct a study to assess the safety of gastric ulcer and random gastric biopsies in the setting of an overt UGIB. Methods This is a retrospective study conducted at a tertiary care center. All patients with a diagnosis of an UGIB who had an esophagogastroduodenoscopy performed with gastric ulcer or a random gastric biopsy were included. Primary outcomes were bleeding and mortality within 30 days. Secondary outcomes included procedure length, rate of H. pylori or cancer diagnosis, and patient follow-up rate. Results Our study included 254 UGIB patients, with only 171 undergoing biopsies. Patients with more severe bleeding using Glasgow-Blatchford Bleeding Score and Rockall Score were less likely to have a biopsy (p < 0.001). There was no statistically significant association between both groups in length of procedure and 30-day mortality (p = 0.482 and p = 0.201, respectively). Patients who underwent biopsies were less likely to be associated with 30-day rebleeding (p = 0.04). There was no difference in H. pylori incidence and cancer detection between the two groups (p = 0.32 and p = 1.0, respectively). Conclusions Gastric biopsies were found to be safe to obtain in the setting of an UGIB and did not increase the risk of 30-day rebleeding or 30-day mortality.