Analysis of the patients admitted to marmara university hospital with non-variceal upper gastrointestinal bleeding [Marmara ünİversİtesİ hastanesİne varİs dişi üst gastroİntestİnal kanama İle başvuran hastalarin deǧerlendİrİlmesİ]

Abstract

Objective: Non-variceal upper gastrointestinal bleeding (NVUGIB) remains an important cause of morbidity and mortality despite the availability of advanced endoscopic techniques for haemostasis. We have described clinical and endoscopic features of the patients with NVUGIB in a teaching hospital. Method: Two hundred and fifty patients admitted between 1996 and 2001 with acute NVUGIB have been evaluated retrospectively. Results: Mean age was 59 and 34.4% were women. Ingestion of aspirin/non-steroidal anti-inflammatory drugs, steroid or warfarin during the previous week was reported for 59.6%, 2.8%, 9.6% of the patients, respectively. Previous upper gastrointestinal bleeding was reported for 31.8% of the patients. The leading cause of bleeding was peptic ulcer (49.2%), followed by erosions (19.2%) and stomach tumors (10.8%). Lesions were located in the stomach (40%), duodenum (33.6%), at the gastrojejunostomy line (4.4%) and esophagus (4.4%). H. pyloric region was positive in 79.2% of the 48 patients investigated. Endoscopic treatment was applied to 33 patients. Seven cases (2.8%) including 3 which had failed endoscopic therapy had a surgical intervention. Six patients (2.4%) died. Conclusion: The main cause of bleeding was peptic ulcer. The majority of patients had either an H. pylori infection or an offending drug use. Since the etiology of bleeding was amenable to treatment, the rate of endoscopic and surgical treatment and mortality were low in our patients.