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Clinical and endoscopic evaluation of gastroduodenal haemorrhage
S T Banerjee1, A Chatterjee, S Bhattacharya
1Department of Medicine, NRS Medical College and Hospital, Calcutta.
Insights
Acid peptic diseases, primarily duodenal and gastric ulcers, are the leading causes of upper gastrointestinal bleeding in patients presenting with hematemesis and melena. Endoscopic evaluation is crucial for diagnosing these conditions.
Area of Science:
- Gastroenterology
- Internal Medicine
- Diagnostic Endoscopy
Background:
- Upper gastrointestinal bleeding (UGIB) presents significant diagnostic challenges.
- Hematemesis and melena are common emergency ward presentations requiring prompt etiological investigation.
Purpose of the Study:
- To determine the endoscopic findings in patients presenting with hematemesis and melena.
- To identify the primary causes of upper gastrointestinal hemorrhage in this cohort.
Main Methods:
- Endoscopic evaluation of 100 consecutive patients with hematemesis or melena.
- Data collection on endoscopic diagnoses and patient demographics.
Main Results:
- Acid peptic disease (APD) was the most frequent cause (2/3rds), comprising duodenal ulcers (60%) and gastric ulcers (40%).
- Esophageal varices due to portal hypertension accounted for 5% of cases.
- Gastric malignancy and NSAID-induced gastric erosions were identified in 3% and 6% of cases, respectively.
- A significant 20% of cases had no identifiable endoscopic cause for UGIB.
Conclusions:
- Acid peptic disease is the predominant etiology of UGIB in patients with hematemesis and melena.
- Endoscopy is essential for diagnosing the cause of UGIB, although a subset remains without a clear endoscopic diagnosis.
Abstract:
Endoscopic evaluation of 100 consecutive cases of haematemesis and melaena attending the emergency ward of NRS Medical College, Calcutta 700014 showed that in 2/3rd of all the patients acid peptic disease was the cause of bleeding, out of which 60% was due to duodenal ulcer and 40% was due to gastric ulcer. Five per cent of all the cases were having portal hypertension where the cause of bleeding was oesophageal varices. Gastric malignancy was responsible for bleeding in 3% cases. In about 6% cases bleeding was due to acute gastric erosion caused by NSAID, steroid and other corrosive agents. In 20% patients no apparent cause for upper gastro-intestinal haemorrhage could be detected endoscopically.