Tashfeen Adam, Fatima Javid, Sharbat Khan.
Upper Gastrointestinal bleeding: An etiological study of 552 cases.
J Pak Inst Med Sci Jan ;15(1):845-8.

This paper presents a retrospective study to evaluate the causes of bleeding in 552 patients undergoing upper GI endoscopy for hemetemesis / melena. The study was conducted between 1992 and 2000 in the Department of Gastroenterology at PIMS. The majority of patients were inpatients, while some were referred from other departments within PIMS and some from other hospitals. Oesophageal varices accounted for the majority of the lesions causing upper GI bleeding (44%). Peptic ulcer disease was the second commonest accounting for 19.7% of cases. Oesophageal lesions like esophagitis and esophageal ulcers were seen in 6.6%. Tumours of the upper GI tract were found in 1.1% and gastric erosions in 4.9%. Fundal varices were seen in 3.8%. Normal upper GI examination on endoscopy accounted for 10.9% and a variety of other lesions in the remaining 10%. The age variation showed a maximum number of patients falling in the age group 50-59 years (22.6%) followed closely by patients between the ages of 60-69 years (19.9%). A significant number of patients had a combination of lesions on endoscopy. The commonest associated lesions were oesophagitis, antral gastritis, portal hypertensive gastropathy, gastric erosions and duodenitis. These were present in combination with other lesions like varices, ulcers and Mallory Weiss tears, and were not considered to be the primary cause of the upper GI bleed. It was concluded that the causes of upper GI bleeding in our series of 552 patients are similar to those described in local literature but different from the causes described in Western literature.

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