Upper gastrointestinal system hemorrhage in the emergency department

In the present study, we aimed to investigate demographic and clinical characteristics of the cases presented to the Emergency Department with an acute upper gastrointestinal system hemorrhage, and to identify the initial evaluation and treatments along with explaining possible causes of hemorrhage.

This prospective study was conducted between October 1, 2006 and September 30, 2007. Characteristics of the patients were evaluated in terms of age, gender, presenting symptoms, medical history, risk factors, coexisting symptom and diseases, results of the rectal examination and nasogastric evaluation, endoscopy findings, received treatments, duration of Emergency Department stay, admitting departments, and outcomes.

128 patients who presented to the Emergency Department during the study period were included in the study. As 27.3 % of the patients were female, 72.7 % were male. The mean age was 59.3 (+/- 16). 51.6 % of patients had a history of NSAID and aspirin use. Endoscopy was performed in 111 (86.7 %) patients. The most common finding among endoscopy results was gastric ulcer with a rate of 20.4 % followed by duodenal ulcer in 18.3 %. The mean hospitalization period in the Emergency Department was found to be 18 hours.

In conclusion, acute upper gastrointestinal hemorrhages are first evaluated and treated in Emergency Departments. Endoscopy was carried out on most of the patients during the monitoring in the Emergency Department. NSAIDs and aspirin are still the most important risk factors and peptic ulcer is the most frequently encountered underlying cause (Tab. 4, Fig. 1, Ref. 27). Full Text in free PDF www.bmj.sk.