Endoscopic findings and outcomes of upper gastrointestinal bleeding patients in northern Iran population referred to the emergency department

Authors

  • Seyyed Abbas Hashemi Mazandaran University of Medical Sciences, Sari, Iran,
  • Seyed Mohammad Valizadeh Mazandaran University of Medical Sciences, Sari, Iran,
  • Sanaz Gonoodi Mazandaran University of Medical Sciences, Sari, Iran,
  • Iradj Maleki Mazandaran University of Medical Sciences, Sari, Iran,

DOI:

https://doi.org/10.14739/2310-1237.2019.1.166175

Keywords:

upper gastrointestinal hemorrhage, endoscopy, Iran, treatment outcome

Abstract

Gastrointestinal bleeding is one of the reasons that patients referred to the emergency department. In the majority of these patients, the bleeding stops spontaneously but some of them are high risk patients who may experience complications and may need endoscopic and surgical treatment. Mismanagement of these cases leads to high mortality. Different studies evaluated the causes of Upper GI bleeding but there is not any information about the distribution of these reasons in north of Iran.

Methods and material. This prospective study included patients with history of upper gastrointestinal bleeding between January 2017 and December 2018. A total of 224 patients underwent endoscopy for UGIB and the data were studied. Follow up was done for occurrence of re-bleeding or mortality.

Results. Our study revealed that the most common cause of upper GI bleeding was duodenal ulcer and gastric ulcer. Antrum was the main anatomical site for gastric ulcer. After the 15 days follow up in 17 (6.8 %) patients mortality existed and rebleeding was found in 11 (4.4 %) patients and the need for surgery in 3 (1.2 %) patients.

Conclusions. Like many parts of the world the most common source of upper gastrointestinal bleeding in our study was peptic ulcer diseases. Our study revealed that despite all diagnostic and treatment procedures still there is mortality (6.8 % mortality existed) due to GI bleeding.

 

References

Nadler, M., & Eliakim, R. (2014) The role of capsule endoscopy in acute gastrointestinal bleeding. Therap Adv Gastroenterol, 7(2), 87–92. doi: 10.1177/1756283X13504727

Saleem, S., & Thomas, A. L. (2018) Management of Upper Gastrointestinal Bleeding by an Internist. Cureus, 10(6), e2878. doi: 10.7759/cureus.2878

Alzoubaidi, D., Lovat, L. B.., & Haidry, R. (2019) Management of non-variceal upper gastrointestinal bleeding: where are we in 2018? Frontline Gastroenterol., 10(1), 35–42. doi: 10.1136/flgastro-2017-100901

Lenti, M. V., Pasina, L., Cococcia, S., Cortesi, L., Miceli, E., Caccia Dominioni, C., et al. (2019) REPOSI Investigators.Mortality rate and risk factors for gastrointestinal bleeding in elderly patients. Eur J Intern Med., 61, 54–61. doi: 10.1016/j.ejim.2018.11.003

Brunner, F., Berzigotti, A., & Bosch, J. (2017) Prevention and treatment of variceal haemorrhage in 2017. Liver Int., 37(Suppl 1), 104–115. doi: 10.1111/liv.13277

Oakland, K., Chadwick, G., East, J. E., Guy, R., Humphries, A., Jairath, V., et al. (2019) Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut., 68(5), 776–789. doi: 10.1136/gutjnl-2018-317807

Stanley, A. J., & Laine, L. (2019) Management of acute upper gastrointestinal bleeding. BMJ., 25, 364, l536. doi: 10.1136/bmj.l536.

Gerson, L. B., Fidler, J. L., Cave, D. R., & Leighton, J. A. (2015) ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding. Am J Gastroenterol., 110(9), 1265–87. doi: 10.1038/ajg.2015.246

Nelms, D. W., & Pelaez, C. A. (2018) The Acute Upper Gastrointestinal Bleed. Surg Clin North Am., 98(5), 1047–1057. doi: 10.1016/j.suc.2018.05.004

Van Leerdam, M. E. (2008) Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol, 22(2), 209–24. doi: 10.1016/j.bpg.2007.10.011

Suba, M., Ayana, S. M., Mtabho, C. M., & Kibiki, G. S. (2010) The etiology, management and clinical outcome of upper gastrointestinal bleeding among patients admitted at the Kilimanjaro Christian Medical Centre in Moshi, Tanzania. Tanzania journal of Health Research., 12(4), 304–308. doi: 10.4314/thrb.v12i4.51073 •

Kim, J. J., Sheibani, S., Park, S., Buxbaum, J., & Laine, L. (2014) Causes of bleeding and outcomes in patients hospitalized with upper gastrointestinal bleeding. J Clin Gastroenterol., 48(2), 113–8. doi: 10.1097/MCG.0b013e318297fb40

Elwakil, R., Reda, M. A., Abdelhakam, S. M., Ghoraba, D. M., & Ibrahim, W. A. (2011) Causes and outcome of upper gastrointestinal bleeding in Emergency Endoscopy Unit of Ain Shams University Hospital. J Egypt Soc Parasitol., 41(2), 455–67.

Alema, O. N., Martin, D. O., & Okello, T. R. (2012) Endoscopic findings in upper gastrointestinal bleeding patients at Lacor hospital, northern Uganda. Afr Health Sci., 12(4), 518–521. doi: 10.4314/ahs.v12i4.19

Telaku, S., Kraja, B., Qirjako, G., Prifti, S., & Fejza, H. (2014) Clinical outcomes of nonvariceal upper gastrointestinal bleeding in Kosova. Turk J Gastroenterol., 25(Suppl 1), 110–5. doi: 10.5152/tjg.2014.4351

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How to Cite

1.
Hashemi SA, Valizadeh SM, Gonoodi S, Maleki I. Endoscopic findings and outcomes of upper gastrointestinal bleeding patients in northern Iran population referred to the emergency department. Pathologia [Internet]. 2019May13 [cited 2024Nov.23];(1). Available from: http://pat.zsmu.edu.ua/article/view/166175

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Original research