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Original Article

Endoscopic Evaluation of Upper Gastrointestinal Bleeding in Patients Presenting with Hematemesis within 24 Hours of Admission

Aslam Ghouri, Santosh Kumar, Safia Bano, Soniha Aslam, Muhammad Hanif Ghani.

OBJECTIVE: To evaluate with endoscopy the common causes of upper gastrointestinal
bleeding in patients presenting with hematemesis within 24 hours of admission.
DESIGN: A cross sectional observational study.
SETTING: Medical unit III, LUMHS Jamshoro.
DURATION: Six months from 1st Jul, 2014 - 31st Dec, 2014.
METHODS: One hundred cases of hematemesis were included in the study. Patients who
refused endoscopy and those on NSAIDs, anticoagulants & steroids were excluded from study.
Upper gastrointestinal endoscopy was performed within 24 hours of admission.
RESULTS: Out of 100 patients selected, 51 (51%) were males and 49 (49%) females. Majority of
patients were between 30-60 years with mean age of 43.97 years ±SD 7.8. Variceal bleed was
the most common cause n=54 (54%) followed by peptic ulcer disease (PUD) n=20 (20%).
Esophagitis was noted in ten (10%) patients, gastric erosions in nine (9%), tumors of upper
gastrointestinal tract in six (6%) and Mallory-Weiss tear was responsible in only one (1%) cases.
CONCLUSION: Variceal bleeding secondary to portal hypertension is the most frequent cause
of bleeding in upper gastrointestinal tract. Increased prevalence of hepatitis B virus (HBV) and
hepatitis C virus (HCV) in this part of the world has resulted in increased incidence of liver
cirrhosis and portal hypertension highlighting the importance of prevention of HBV and HCV.

Key words: Upper gastrointestinal bleeding, Varices, Peptic ulcer disease, Endoscopy, Hepatitis.

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