ETIOLOGICAL PATTERN AND OUTCOME OF NON-VARICEAL UPPER G.I. BLEEDING

ABSTRACT Background: Upper GI bleeding is one of the most frequently encountered emergencies worldwide. This study was designed to analyze the diagnostic accuracy of upper GI endoscopy, to explore the etiology of upper GI bleeding where the causes are other than varices and to evaluate the clinical outcome in terms of efficacy of treatment and prognosis. Material & Methods: This was a descriptive study, which was conducted at Military Hospital Rawalpindi, in which a total of 198 patients with Non-variceal Upper GI bleeding were included. After initial resuscitation, endoscopy was performed within 48 hours of presentation. The study was designed to assess the etiological pattern of non-variceal upper GI bleeding and clinical outcome. Results: 158 (80%) patients were male, with male to female ratio of 4:1 and a mean age 49.6 (S.D. 13.9) years. A bleeding site could be detected in all patients. 72% patients presented with hematemesis alone, whereas melena was reported in 22% patients and concomitant hematemesis with melena were the presenting manifestations in 6% patients. Previous history of NSAIDs intake was obtained in 44% of patients. Major causes of Non-variceal upper GI bleeding were peptic ulcer (34%), gastric erosions (32%), malignancy (8%), and reflux esophagitis (8%). The majority of patients (80%) had potentially curable disease and recovered when reevaluated. Emergency surgery was seldom necessary and no mortality was reported. Conclusion: UGI endoscopy proved an appropriate diagnostic tool and provided a good knowledge about the etiological pattern of non-variceal upper GI bleeding. Non-variceal causes contributed to the morbidity predominantly.