Salman Shakeel, Muhammad Imran Hasan Khan, Ghias Un Nabi Tayyab, Ehsan Ullah, Asif Mehmood, Maryam Zulfiqar.
Upper gastrointestinal bleed; patterns of endoscopic findings in patients in Lahore general hospital, Lahore.
Professional Med J Jan ;23(10):1247-51.

Acute Upper Gastrointestinal Bleed (UGIB) is a globally prevalent medical emergency and is a major cause of mortality. It may manifest as Hematemesis, Melena or Hemetochezia. The most common causes of UGIB are Esophageal Varices (EV) and Peptic Ulcer Disease (PUD). Upper GI endoscopy (EGD) is the preferred procedure for investigation. Objectives: This study was carried out to identify patterns of endoscopic findings in patients with UGIB and its frequency according to age, gender and symptoms in our setup. Study Design: It was a single centered retrospective analysis. Setting: Endoscopy floor of Lahore General Hospital, Lahore for evaluation of Upper GI Bleed. Period: January 2010 to December 2013. Material & Methods: 3910 patients were brought to the GI Endoscopy. Data was collected from the endoscopy records on demographics (age and gender) and history of UGIB. The endoscopic findings were then evaluated. Results: 58.3% were male and 41.7% were female; male to female ratio was (1.4:1). The mean age was 43.4 years for males and 46.9 years for females. (58%) had hemetemesis, (21%) had melena, (19%) had both hemetemesis and melena. (2%) had hemetochezia. EV (69.2%) was the commonest cause of UGIB followed by PUD (20.6%). 4.3% of patients had a normal endoscopy and 2.5 % had Growth in upper GI tract. Conclusions: EV was the commonest cause of UGIB in our setup, as compared to the western world, where PUD was more common. Probable reason could be the high prevalence of liver cirrhosis in our population. A good number of patients had a normal endoscopy, suggesting physicians to obtain detailed history prior to the procedure.

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