Causes of severe upper gastrointestinal bleeding on the basis of endoscopic findings

ABSTRACT

To describe the common causes of severe upper gastrointestinal [GI] bleeding in a tertiary care teaching hospital. This study was carried out in Gastroenterology Department Postgraduate Medical Institute, Hayatabad Medical Complex Peshawar from 1st September 2003 to 31st July 2005. Study was conducted on all patients who presented with severe upper GI bleeding. The patients were first stabilized hemodynamically and were kept empty stomach for at least 6-12 hours before procedure. Upper GI endoscopy was performed and the endoscopic findings were recorded. Out of 350 patients included in the study, 200 [57%] were males and 150 [43%] were females. The age ranged from 14 years to 75 years. Variceal bleed was the most common cause in 45.7% [n=160] cases followed by peptic ulcer in 31.4% [n=110] cases. Gastroesophageal reflex disease was noted in 10% [n=35], carcinoma of the stomach in 5.7% [n=20] of the cases and Mallory-Weiss tears in 4% [n=14] cases. Out of 160 patients with varices, 62.5% [n=100] were having esophageal varices. Out of 110 peptic ulcer cases, 63.6% [n=70] were having duodenal ulcer and 26.4% [n=29] were having NSAID induced peptic erosions. Variceal bleeding secondary to portal hypertension and peptic ulcer diseases are the most common causes of upper G I bleeding in our setup