Koushik Chakma1, Saumik Chakraborty2, Avik Chakraborty3
BACKGROUND
Upper gastrointestinal bleeding (UGIB) is one of the common medical emergencies
throughout the world that may require hospital admission and results in high
patient morbidity and mortality. The presentation of UGI bleeding depends on the
amount and location of haemorrhage. Upper gastrointestinal endoscopy (UGIE) is
the preferred investigative procedure for UGIB because of its accuracy, low rate
of complication, and its potential for therapeutic interventions. The present study
has been carried out to evaluate the different aetiological causes of UGIB in a
tertiary care centre in the North Eastern part of India and compare the same with
other studies done globally.
METHODS
This was a hospital based observational study with cross sectional design carried
out in the Department of Medicine at Tripura Medical College & DR BRAM Teaching
Hospital, Agartala. Total 376 patients were selected for this study for over a period
of 2 years from January 2017 to December 2018. Upper GI endoscopy was
performed in all patients after hemodynamic stabilisation. Rockall scoring system
was used in non-variceal cases to predict the mortality in patients with upper GI
bleeding.
RESULTS
A total of 376 patients had endoscopy for UGIB which included 260 (69.1 %) males
and 116 (30.9 %) females, and the mean age was 47.9 (± 17.0) years. The most
common cause of UGIB was peptic ulcer disease (duodenal ulcer and gastric ulcer)
consisting of 31.38 %, followed by erosive gastritis (23.94 %), oesophageal varix
(11.17 %), portal hypertensive gastropathy (10.64 %), duodenitis (8.51 %).
Gastrointestinal malignancy (gastric and oesophageal cancers) was reported in
3.98 % and rare causes of UGIB were Mallory-Weiss syndrome (1.86 %), and
esophagitis (1.60 %). Among them 4.26 % of the patients had normal endoscopy
findings.
CONCLUSIONS
In the present study, peptic ulcer disease was the most common cause of upper
gastrointestinal bleeding, followed by erosive gastritis. Rockall score of more than
4 was numerically associated with increased incidence of mortality.
