UPPER GASTROINTESTINAL BLEED;

PATTERNS OF ENDOSCOPIC FINDINGS IN PATIENTS IN LAHORE GENERAL HOSPITAL, LAHORE

Abstract

Acute Upper Gastrointestinal Bleed (UGIB) is a globally prevalent medical
emergency and is a major cause of mortality. It may manifest as Hematemesis, Melena or
Hemetochezia. The most common causes of UGIB are Esophageal Varices (EV) and Peptic
Ulcer Disease (PUD). Upper GI endoscopy (EGD) is the preferred procedure for investigation.
Objectives: This study was carried out to identify patterns of endoscopic findings in patients
with UGIB and its frequency according to age, gender and symptoms in our setup. Study
Design: It was a single centered retrospective analysis. Setting: Endoscopy floor of Lahore
General Hospital, Lahore for evaluation of Upper GI Bleed. Period: January 2010 to December
2013. Material & Methods: 3910 patients were brought to the GI Endoscopy. Data was
collected from the endoscopy records on demographics (age and gender) and history of UGIB.
The endoscopic findings were then evaluated. Results: 58.3% were male and 41.7% were
female; male to female ratio was (1.4:1). The mean age was 43.4 years for males and 46.9 years
for females. (58%) had hemetemesis, (21%) had melena, (19%) had both hemetemesis and
melena. (2%) had hemetochezia. EV (69.2%) was the commonest cause of UGIB followed by
PUD (20.6%). 4.3% of patients had a normal endoscopy and 2.5 % had Growth in upper GI tract.
Conclusions: EV was the commonest cause of UGIB in our setup, as compared to the western
world, where PUD was more common. Probable reason could be the high prevalence of liver
cirrhosis in our population. A good number of patients had a normal endoscopy, suggesting
physicians to obtain detailed history prior to the procedure.