ENDOSCOPIC FINDINGS IN PATIENTS PRESENTING WITH UPPER GI BLEED IN A TERTIARY CARE FACILITY
Objective: To determine the frequency of different causes of upper gastrointestinal bleed in patients presenting to emergency department.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017.
Methodology: Patients with age 14-80 years presenting to emergency department with upper gastrointestinal bleed either in form of hematemesis, melena or hematochezia were offered endoscopic study after resuscitation and the findings noted and segregated according to age, gender and etiology.
Results: A total of 367 patients were enrolled, of which 77.1% were males and 22.9% females with a mean age of 54.7 ± 16. The most common endoscopic finding was esophageal varices (36.5%), followed by duodenal ulcers (7.3%), non-specific findings (5.2%), reflux esophagitis (4.1%), portal hypertensive gastropathy with gastric antral-vascular ectasia (3.2%), fundal varices (2.7%) and gastric ulcers (2.4%). Negative endoscopy with normal findings accounted to about 22.6%, making it the second most common finding in the study.
Conclusion: Portal hypertension secondary to decompensated cirrhosis by hepatitis C is the most common cause of upper gastrointestinal bleed followed by duodenal ulcers, non-specific findings, reflux esophagitis and gastric ulcers.