Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal

  • Mukesh Sharma Paudel Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Sudhamshu KC Hepatology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Amrendra Kumar Mandal Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Nandu Silwal Poudyal Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Ramila Shrestha Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Bidhan Nidhi Paudel Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Sitaram Chaudhary Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal

Abstract

Introduction: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community.
Methods: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu. We identified the culprit lesions by upper gastrointestinal endoscopy.
Results: The average age of patients with AUGIB was 51.6 years with 59 (59%) males. Duodenal ulcers are most common 29 (29%), followed by varices 23 (23%) and gastric ulcers 14 (14%). More than one lesion was identified in 38 (38%) patients. Patients with variceal bleed were more likely to present with hematemesis alone as compared to those with ulcer bleed (p=0.005). Variceal bleed patients presented earlier to the hospital (p=0.005), had lower MAP at presentation (p=0.0002), had lower hemoglobin level (p=0.0001) and higher serum creatinine level at presentation (p=0.001). Patients with variceal bleed were more likely to have consumed alcohol 20 (86.9%) and patients with ulcer bleed were more likely to be smokers 29 (67.4%) or consume tobacco 14 (32.5%) (p=0.006).
Conclusions: Ulcer related bleeding is still the most common cause of AUGIB. Many patients with AUGIB have more than one lesions identified during upper gastrointestinal endoscopy.
Keywords:  bleeding; endoscopy; peptic ulcer; upper gastrointestinal;varices. [PubMed]

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Published
2017-06-28
How to Cite
PAUDEL, Mukesh Sharma et al. Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal. Journal of Nepal Medical Association, [S.l.], v. 56, n. 206, june 2017. ISSN 1815-672X. Available at: <http://jnma.com.np/jnma/index.php/jnma/article/view/3120>. Date accessed: 23 oct. 2017.
Section
Original Article

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