Clinical findings, early endoscopy, and multivariate analysis in patients bleeding from the upper gastrointestinal tract.

Morgan, A. G.; McAdam, W A; Walmsley, Gemma; Jessop, Aaron; Horrocks, Jane C.; Dombal, F. T. de

doi:10.1136/bmj.2.6081.237

Cited by 94 publications

(28 citation statements)

References 6 publications

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“…Nevertheless, when compared to American studies (10,23) , we found fewer patients with gastritis (8.5% vs 13% and 23%, respectively). In respect to the diagnosis of gastritis, our diagnostic profile is similar to that found in European studies, but the prevalence of bleeding from varices is greater among our patients (17,22,28) . This finding may be explained by the fact that a quarter of our patients presented previous evidence of portal hypertension, and that in agreement with other studies (19,26) , varices were the most common source of bleeding in such patients.…”

Section: Discussionsupporting

confidence: 64%

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Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records

Zaltman

Souza

et al. 2002

Arq. Gastroenterol.

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-Background -Upper gastrointestinal bleeding is a frequent and potentially severe complication of most digestive diseases of the upper gastrointestinal tract. Upper endoscopy has a crucial role in the diagnosis and treatment of upper gastrointestinal bleeding, however epidemiological studies are still limited in our country. Aims -To assess the clinical characteristics, endoscopic accuracy, treatment efficiency and clinical outcome of patients admitted to the endoscopic unit with upper gastrointestinal bleeding. Methods -A retrospective study of consecutive records from patients who underwent emergency endoscopy for upper gastrointestinal bleeding was performed during a period of 2 years. Results -Most patients were male 68.7%, with a mean age of 54.5 ± 17.5 years. A bleeding site could be detected in 75.6% of the patients. Diagnostic accuracy was greater within the first 24 hours of the bleeding onset, and in the presence of hematemesis. Peptic ulcer was the main cause of upper gastrointestinal bleeding (35%). The prevalence of variceal bleeding (20.45%) indicates a high rate of underlying liver disease. Endoscopic treatment was performed in 23.86% of the patients. Permanent hemostasis was achieved in 86% of the patients at the first endoscopic intervention, and in 62.5% of the patients after rebleeding. Emergency surgery was seldom necessary. The average number of blood units was 1.44 ± 1.99 per patient. The average length of hospital stay was 7.71 ± 12.2 days. Rebleeding was reported in 9.1% of the patients. The overall mortality rate of 15.34% was significantly correlated with previous liver disease. Conclusions -Diagnostic accuracy was related to the time interval between the bleeding episode and endoscopy, and to clinical presentation. Endoscopic therapy was an effective tool for selected patients. The resulting increased duration of hospitalization and higher mortality rate in the patients submitted to therapeutic endoscopy were attributed to a higher prevalence of variceal bleeding and underlying liver disease.

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Section: Discussionsupporting

confidence: 64%

“…Similarly to other surveys (8,10,17,22,27,28) the most common bleeding lesion identified at upper GI endoscopy was peptic ulcer disease, duodenal ulcer being more common than gastric ulcer. Nevertheless, when compared to American studies (10,23) , we found fewer patients with gastritis (8.5% vs 13% and 23%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records

Zaltman

Souza

et al. 2002

Arq. Gastroenterol.

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“…The presence of comorbidity is a well-known cause of increased incidence for upper gastrointestinal system bleeding, and accordingly, nearly 60% of our patients had comorbid diseases (3,12). Peptic ulcer remains the most common cause of upper gastrointestinal bleeding, representing approximately half of all cases; other less common but appreciably frequent causes of non-variceal upper gastrointestinal bleeding include erosions, esophagitis, Mallory-Weiss tears, and malignancy (1,3,5,9,11). In this retrospective study, we confirmed that endoscopy contributed to identification of the bleeding site in nearly all the patients.…”

Section: Discussionmentioning

confidence: 96%

A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey

Bor¹,

Dağlı²,

Sarer³

et al. 2011

Turk J Gastroenterol

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“…This difficulty is compounded in the tropics because very little has been written about the problems of treating such patients in these countries (Tandon, 1978). The causes of haemorrhage are different, (Wicks et al, 1975;Morgan et al, 1977;Anand et al, 1983) sophisticated instruments for diagnosis are not available, there is a shortage of blood for transfusion and skilled and experienced surgeons are rare. This article aims to place in perspective the problem of upper gastrointestinal (GI) haemorrhage in the tropics particularly in India and discusses appropriate methods of management.…”

Section: Introductionmentioning

confidence: 99%

The management of upper gastrointestinal haemorrhage in a tropical country.

Rao¹,

Pande²,

Sahni³

et al. 1991

Emergency Medicine Journal

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Clinical findings, early endoscopy, and multivariate analysis in patients bleeding from the upper gastrointestinal tract.

Cited by 94 publications

References 6 publications

Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records

Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records

A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey

The management of upper gastrointestinal haemorrhage in a tropical country.

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