Causes of upper gastrointestinal bleeding: Experience at a major hospital in Riyadh

Over a period of 14 years, 1246 patients had emergency gastroscopy because of upper gastrointestinal tract (UGIT) bleeding. The endoscopic findings in these patients showed duodenal ulcer disease (DUD) in 364 (29.2%) was the most common followed by esophageal varices in 302 (24.2%), erosive gastritis in 198 (15.9%), gastroesophageal reflux disease (GERD) in 156 (12.5%), gastric ulcer in 69 (5.5%), and normal (negative) endoscopy in 132 (10.6%). Only 65 (21.5%) patients with varices had active bleeding from the esophageal varices, 10 (3.3%) from the gastric varices and in 34 other patients with varices (11.3%), the bleeding was mainly from associated gastrophy. Eighty-six patients (23.6%) with DUD had active bleeding at endoscopy; 66 (80.5%) of these had ulcers showing stigmata of recent hemorrhage. Of those who had active bleeding, the source of the bleeding could not be identified in only five.