HomePhilippine Scientific Journalvol. 50 no. 1 (2017)

A 5-year Retrospective Study on Upper Gastrointestinal Bleeding Based on Esophago-gastro-duodenoscopy in Manila Central University Hospital

Avegail A. Abella | Gerard Perlas

 

Abstract:

Background: Upper Gastrointestinal Bleeding (UGIB) is defined as bleeding within the intraluminal gastrointestinal tract between the upper esophagus to the duodenum at the ligament of Treitzwhich is considered as one of the important medical emergencies worldwide. Objective: To determine the etiology of UGIB based on endoscopic-findings among patients in a tertiary hospital in Manila. Materials and methods: This is a retrospective study derived from a review of the medical records and endoscopy record book from January 2010 to December 2014. The clinical data was reviewed and analysed with emphasis on the etiology of UGIB. Results: A total of 508 patients diagnosed of UGIB who underwent endoscopy during the study period were included. The mean age was 61.48 years, 57.1% were males and 42.9% females (1.3:1). Most common presentation was melena (80.7%), majority were managed medically (79.5%) while other underwent endoscopic intervention (20.5%). Conclusion: Melena was the most common clinical presentation of UBIG due to gastric ulcer. Esophago-gastro-duodenoscopy is essential in identifying the source of bleeding which also facilitated endoscopic therapeutic intervention.



References:

  1. Loren L. Gastrointestinal Bleeding. In: Braunwald E, Fauci AS, Dasper DL, Hauser SL, Longo DL, Jameson JL. Harrison’s Principle of Internal Medicine. USA: McGraw-Hill Companies Inc; 2005 p235.
  2. Silverstein FE, Gilbert DA, Tedesco FJ et al. The national ASGE survey on upper gastrointestinal bleeding.I, Study design and baseline data. Gastrointestinal Endoscopy. 1981:27:73-9
  3. Larson DE, Farnell MB. Upper gastrointestinal hemorrhage. Mayo clinproc 1983:58:371-87
  4. Palmer ED. Upper gastrointestinal hemorrhage. JAMA1975:231:853-5
  5. Jutabha R, Jensen MD. Management of Upper Gastrointestinal Bleeding in patients with chronic liver disease. Med Clin North Am 1996; 80(5); 1035-1068
  6. Fallah MA, Prakash C, Edmundowiez S. Acute gastrointestinal bleeding. Med Clin North Am 2000:84(5):1183-208
  7. Kandapa K, Aruny JE. Acute gastrointestinal bleeding. In: Handbook of interventional radiologic procedures 2nd ed. USA: Lippincott Williams & Wilkins; 1996 p.130-8
  8. Spiegel BM, Vakil NB, Ofman JJ. Endoscopy for acute non variceal upper gastrointestinal tract hemorrhage: is sooner better? A systematic review. Arch Intern Med. 2001: 161(11): 1393-404
  9. Lee JG, Turnipseed S, Romano PS, Vigil H, Azari R, et al. Endoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding. A randomized controlled trial. Gastrointestinal Endosccopy. 1999: 50(6):755-61
  10. Alema ON., Martin DO, Okello TR. Endoscopic findings in upper gastrointestinal bleeding patients at Lacor hospital, northern Uganda. African Health Sciences 2012; (4): 518-521
  11. Hreinsson J., Kalaitzakis E., et al. Upper Gastrointestinal Bleeding: incidence, etiology and outcomes in a population-based setting. Scandinavian J Gastroenterol 2013; 48: 439-447
  12. Wong S.N., Sollano J.D., Chan M.M., Carpio R.E., et al. Changing Trends in Peptic Ulcer prevalence in a Tertiary Care setting in the Philippines: A seven-year study. Journal of Gastroenterology and Hepatology, 2005: vol 20, Issue 4, 628-632
  13. Elguel, A. The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a restrospective case series analysis. Libyan Journal of Medicine 2011, 6: 6283
  14. Gurung RB., Joshi G., Gautam N., Pant P., Pokhrel B., Koju R., Bedi TRS. Upper gastrointestinal bleeding: Etiology and demographic profile based on endoscopic examination at Dhulikhel Hospital, Kathmandu University Hospital. Kathmandu University Medical Journal 2010, 8(2);208-21
  15. World Health Organization. The World Health Report 2003. http://www.who.int/whr/2003/chapter1
  16. Charatcharoenwitthaya P., et al. Characteristics and outcomes of acute upper gastrointestinal bleeding after therapeutic endoscopy in the elderly: World J Gastroenterol. 2011 Aug 28; 17(32): 3724–3732.
  17. L. A. Button L.A., Roberts S.E., Evans P. A.,et al. Hospitalized incidence and case fatality for upper gastrointestinal bleeding from 1999 to 2007: a record linkage study. Alimentary Pharmacology & Therapeutics 2011; 33: 64–76.
  18. Chitsaeng S., Nimanong S., Prachayakul V., et al. Endoscopy for Upper Gastrointestinal Bleeding Occurring in Hospitalized Patients: Findings and Impacts on Patient Management. Thailand Journal of Gastroenterology 2012; 13 (1): 10-14