Endoscopic Findings in 972 Cases of Upper GI Bleeding at Maharat Nakhon Ratchasima Hospital in 1997-1998
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Abstract
Introduction: Upper gastrointestinal (GI) bleeding is one of the most common problems in Maharat Nakhon Ratchasima hospital. It is considered emergent and life threatening. Upper GI endoscopy is the mainstay for diagnosis and treatment.
Objective: To report the characteristic of patients, causes and therapeutic endoscopic treatment of upper GI bleeding at Maharat Nakhon Ratchasima hospital in 1997-1998.
Patients and Methods: The patients recruited in this retrospective study were investigated with upper GI endoscopy because of upper GI bleeding.
Results: There were 972 patients, male : female 2.4:1. Most of them were fifty year old or older. The main presenting symptom was hematemesis and melena. Associated risk factors included alcoholic drinking and nonsteroidal anti-inflammatory drugs (NSAIDs) uses. Initially, most patients had anemia due to severe blood loss. The main endoscopic findings were gastric ulcer (GU), gastritis and ruptured esophageal varices (32.9, 31.5 and 16.2 percent, respectively). Unidentified cause was 5.7 percent. The characteristics of gastric ulcer were as follow; number of ulcer 1.5+1 diameter 2.1+1.8 cm, clean base 79.9 percent. The main sites were at antrum (especially prepylorus) and body (especially lesser curve) 42.3 and 36.6 percent respectively. The rupture of esophageal varices was more commonly found as compared to other previous studies. The less common finding was duodenal ulcer (DU) of which the characteristics were as follow; number of ulcer 1.1+0.4 diameter 1.4+0.8 cm, clean base 77.2 percent. Most of DU were found in the first part of duodenum.
Conclusions: Upper GI endoscopy is the necessary method for identification the causes of upper GI bleeding.
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