Endoscopic Profile of Acute Upper Gastrointestinal Bleed in Adults

Abstract

Background: Acute upper gastrointestinal bleeding (UGIB) is one of the most common causes of medical emergencies and associated with high morbidity and mortality in adults. Although there is decline in peptic ulcer bleed as an etiology of acute UGI bleed due to discovery of proton pump inhibitors, the Emergency Room (ER) visits for UGI bleed are increasing due to other etiologies including variceal bleed and drug-induced gastrointestinal (GI) bleed. This study was designed with the aim to assess the endoscopic profile of UGIB presenting to our tertiary care center in south India. Materials and Methods: This was a prospective analytical study. It was done over a period of 6 months from January 2020 to June 2020. All adult patients presenting with acute hematemesis and/or melena were included in the study. All included patients underwent detailed history, clinical examination, blood tests, and upper GI endoscopy. Results: One hundred and eighty-two patients were included in the study. Out of 182 patients, 76% were males. The most common age group was 51–60 years contributing to 34%. The commonest presentation was hematemesis than that of melena. Out of all patients, 69% of patients were hemodynamically stable and 31% patients were unstable at the time of admission. The causes of bleed included esophageal varices, gastric varix, peptic ulcer, portal hypertensive gastropathy (PHG), Mallory-Weiss tear, gastric cancer, drug-induced gastritis, and esophageal tear. Variceal bleed was the most common cause of UGI bleed comprising 34.16% of cases. Conclusions: From our study, we conclude that the most common cause of upper GI bleed in our part of India is portal hypertension related bleeding which included esophageal varices, gastric varices, and severe PHG. This was in contrary to most of the studies from other part of the country as peptic ulcer is far more common than variceal bleed in other studies.