Upper gastrointestinal bleeding in Surin Hospital : a retrospective study
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Abstract
Objective: Upper gastrointestinal bleeding is a frequent and potentially serious complication of most upper gastrointestinal tract diseases. Esophago-gastroduodenoscopy (EGD) is generally indicated for the management of patients admitted with upper gastrointestinal (GI) bleeding, however epidemiological studies are still limited in our region.
Objective: To evaluate the clinical characteristics, endoscopic findings, effectiveness of endoscopic treatment, and clinical outcomes of patients admitted to Surin Hospital with upper gastrointestinal bleeding, and to study the prevalence and role of Helicobacter pylori in patients with upper gastrointestinal bleeding
Setting: Endoscopic Unit, Department of internal medicine, Surin Hospital.
Research design: Retrospective study.
Material: 802 patients with upper gastrointestinal (GI) bleeding in Surin Hospital from January 2005 - December 2006 were included in the study.
Methods: A retrospective study of medical records from patients who underwent emergency endoscopy for upper gastrointestinal bleeding was performed during a period of 2 years.
Results: Most patients were male (64%), with a mean age of 57.11 ± 14.27 years. Most common cause of upper gastrointestinal bleeding was esophageal varices (33.5%). Helicobacter pylori could be detected in non variceal bleeding patients 46% by rapid urease test and was associated with duodenal ulcer more than gastric ulcer (71.9% vs 50.3%, p < 0.05). The high prevalence of variceal bleeding (34.1%) indicates a high rate of chronic liver diseases. Permanent hemostasis was achieved in 718 cases (89.5%) of the patients with first endoscopic treatment, and 22 cases (2.7%) required emergency surgery after second attempts for endoscopic intervention. The average length of hospital stay was 4.31 ± 3.03 days. The mortality rate was reported in 4.7% of the patients. Conclusions: In patients with upper gastrointestinal bleeding, Esophagogastro-duodenoscopy (EGD) provides an accurate diagnostic tool and also therapeutic intervention when needed. Variceal bleeding was the major cause of upper GI bleeding in Surin hospital. Early, accurate EGD with appropriate therapeutic intervention is effective and is associated with improved outcomes for patients with upper GI hemorrhage.
Key words: Upper gastrointestinal bleeding, Esophagogastroduodenoscopy, Helicobacter pylori Diploma Thai Board of internal medicine and gastroenterology, Department of internal medicine, Surin Hospital.
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References
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