scholarly journals The Current Portrayal of Non-Variceal Upper Gastrointestinal Bleeding in a Portuguese Tertiary Center

2021 ◽  
pp. 1-6
Author(s):  
Daniela Falcão ◽  
Joana Alves da Silva ◽  
Tiago Pereira Guedes ◽  
Mónica Garrido ◽  
Inês Novo ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Hospital ◽  
Outcome Data ◽  
Surgical Interventions ◽  
Ulcer Disease ◽  
Tertiary Center ◽  
Rockall Score ◽  
Therapeutic Tools ◽  
Upper Gastrointestinal

<b><i>Introduction:</i></b> Non-variceal upper gastrointestinal bleeding (NVUGIB) is an important healthcare problem whose epidemiology and outcomes have been changing throughout the years. The main goal of this study was to characterize the current demographics, etiologies, and risk factors of NVUGIB. <b><i>Methods:</i></b> Analysis of clinical, endoscopic, and outcome data from patients who were admitted for NVUGIB between January 2016 and January 2019 in an emergency department of a tertiary hospital center. <b><i>Results:</i></b> A total of 522 patients were included, with a median age of 71 years, mainly men, with multiple comorbidities. Most patients were directly admitted, while the others were transferred from other hospitals. Peptic ulcer disease was the most common cause of NVUGIB and it was followed by tumor bleeding. Esophagogastroduodenoscopy was performed within &#x3c;12 h after hospital admission in 51.9%. In-hospital rebleeding occurred in 6.9% and overall mortality was 4.2%. Transferred patients had superior Glasgow-Blatchford score (GBS), required more blood transfusion, endoscopic and surgical interventions, and presented higher rebleeding rate, with similar mortality. Complete Rockall score (CRS) and GBS were predictors of endoscopic therapy. Surgery need was only related to CRS. Patients who rebled had superior pre-endoscopic Rockall score (RS), CRS, and GBS. Mortality was increased in patients with higher RS and CRS. <b><i>Discussion/Conclusion:</i></b> Ageing and increasing comorbidities have not been related to worse outcomes in NVUGIB. These findings seem to be the consequence of the correct use of both diagnostic and therapeutic tools in an organized and widely accessible healthcare system.

scholarly journals A Study of Clinical and Endoscopic Profile of Acute Upper Gastrointestinal Bleeding

2015 ◽  
Vol 12 (1) ◽  
pp. 21-25 ◽  
Author(s):  
KR Dewan ◽  
BS Patowary ◽  
S Bhattarai
Keyword(s):  
Gastrointestinal Bleeding ◽  
Scoring System ◽  
Upper Gastrointestinal Bleeding ◽  
Medical Emergency ◽  
Ulcer Disease ◽  
Gastrointestinal Bleed ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleed ◽  
Rockall Score ◽  
Upper Gastrointestinal

Backgroud Acute Upper Gastrointestinal Bleeding is a common medical emergency with a hospital mortality of approximately 10 percent. Higher mortality rate is associated with rebleeding. Rockall scoring system identifies patients at higher risk of rebleed and mortality.Objective To study the clinical and endoscopic profile of acute upper gastrointestinal bleed to know the etiology, clinical presentation, severity of bleeding and outcome.Method This is a prospective, descriptive hospital based study conducted in Gastroenterology unit of College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal from January 2012 to January 2013. It included 120 patients at random presenting with manifestations of upper gastrointestinal bleed. Their clinical and endoscopic profiles were studied. Rockall scoring system was used to assess their prognosis.Result Males were predominant (75%). Age ranged from 14 to 88 years, mean being 48.76+17.19. At presentation 86 patients (71.7%) had both hematemesis and malena, 24 patients (20%) had only malena and 10 patients (8.3%) had only hematemesis. Shock was detected in 21.7%, severe anemia and high blood urea were found in 34.2% and 38.3% respectively. Upper Gastrointestinal Bleeding endoscopy revealed esophageal varices (47.5%), peptic ulcer disease (33.3%), erosive mucosal disease (11.6%), Mallory Weiss tear (4.1%) and malignancy (3.3%). Median hospital stay was 7.28+3.18 days. Comorbidities were present in 43.3%. Eighty six patients (71.7%) had Rockall score < 5 and 34 (28.3%) had >6. Five patients (4.2%) expired. Risk factors for death being massive rebleeeding, comorbidities and Rockall score >6.Conclusion Acute Upper Gastrointestinal bleeding is a medical emergency. Mortality is associated with massive bleeding, comorbidities and Rockall score >6. Urgent, appropriate hospital management definitely helps to reduce morbidity and mortality.Kathmandu University Medical Journal Vol.12(1) 2014: 21-25

scholarly journals Analysis of Clinical Rockall Score in patients with Acute Upper Gastrointestinal Bleeding in the Emergency Services of a Tertiary Hospital

2018 ◽  
Vol 1 (01) ◽  
pp. 31-36
Author(s):  
Olita Shilpakar ◽  
Pratap Narayan Prasad ◽  
Ramesh Kumar Maharjan
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Bleeding ◽  
Emergency Services ◽  
Predictive Accuracy ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Hospital ◽  
University Teaching ◽  
Cross Sectional ◽  
Rockall Score ◽  
Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding is a gastrointestinal emergency. It is characterized by hematemesis or melena or both. Rapid identification and stabilization of patients with upper gastrointestinal bleeding presenting to the emergency department is essential for patient survival. This study was done to inspect the use of the Clinical Rockall score to predict the outcome in patients with Upper gastrointestinal bleeding. Methods: A cross sectional study of 272 patients who presented to the emergency department of Tribhuvan University Teaching hospital within a period of one year with hematemesis or melena or both was performed. The Clinical Rockall Score was calculated for each patient based on the points assigned for clinical variables. Results: The most common cause of upper gastrointestinal bleeding was esophageal varices 86 (31.6%), followed by ulcers 53 (19.5%). Hematemesis was the most common mode of presentation in 133 (48.9%) followed by melaena in 95 (34.9%) and both in 44 (16.2%). High clinical Rockall score of >4 was associated with outcomes like transfusion in 81% patients, rebleeding in 61.9% and mortality in 69% of patients. The predictive accuracy of clinical Rockall score for transfusion, the AUROC was 0.737 (95% CI: 0.678-0.791, P=0.001); for rebleeding, the AUROC was 0.863 (95% CI: 0.8-0.927, P= 0.001) and for mortality, the AUROC was 0.877 (95% CI: 0.81-0.944, P= 0.001). Conclusions: Clinical Rockall Score is a simple and rapid non endoscopic risk score that can be applied at the time of presentation to the emergency department to predict mortality outcomes in patients with acute UGIB.

scholarly journals Diagnosis and management of extrahepatic oesophageal variceal bleed in children in a low resourced setting

2020 ◽  
Vol 54 (4) ◽  
pp. 274-278
Author(s):  
Taiba J. Afaa ◽  
Kokou H. Amegan-Aho ◽  
Elikem Richardson ◽  
Bamenla Goka
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Upper Gastrointestinal Bleeding ◽  
Liver Function Tests ◽  
Tertiary Hospital ◽  
Secondary Prophylaxis ◽  
Resource Constraint ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal

Extrahepatic portal vein obstruction (EHPVO) is a major cause of portal hypertension (PH) in children. Portal vein thrombosis (PVT) is the most common cause accounting for up to 75% of cases in developing countries. Upper gastrointestinal bleeding is the most dreaded and commonest presentation of portal hypertension. Successful treatment of paediatric PH, though challenging is performed in resource constraint countries. Cases: Five children presented over three years to a tertiary hospital in Ghana, with massive upper gastrointestinal bleeding. They had anaemia, thrombocytopaenia and four had splenomegaly. Liver function tests, INR, haemoglobin electrophoresis as well as HIV serology, hepatitis B and C screening were all normal. Abdominal doppler ultrasound scan confirmed portal vein thromboses. They were resuscitated and managed with octreotide, propranolol, antibiotics and sclerotherapy or oesophageal variceal banding in the acute setting and long term secondary prophylaxis with propranolol. Subsequently, an algorithm was developed to assist with the management of bleeding from oesophageal varices and the diagnosis of EHPVO. Conclusion: Portal hypertension due to EHPVO is an important cause of upper gastrointestinal (GI) bleeding in children. This can be successfully managed even in a resource constraint setting once the appropriate measures are taken.

scholarly journals Clinical profile of patients presenting to emergency with upper gastrointestinal bleeding in a tertiary hospital of Nepal

2021 ◽  
Vol 8 (2) ◽  
pp. 105-111
Author(s):  
Sunil Adhikari ◽  
Suraj Rijal ◽  
Darlene Rose House
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Clinical Presentation ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Hospital ◽  
Clinical Profile ◽  
Ulcer Bleeding ◽  
Cross Sectional ◽  
Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding is an acute emergency condition. It is an important cause for the hospital admission. This study descriptively analyses the clinical profile of upper gastrointestinal bleeding presenting to a tertiary hospital in Nepal. Method: This is a cross-sectional study of patients presenting with upper gastrointestinal bleeding from 01 Oct 2018 to 30 Sep 2019 at Patan Hospital Emergency Department, Patan Academy of Health Sciences, Nepal. Patient’s demographics, clinical presentation, duration of illness before presenting to Emergency, vitals, and laboratory parameters were descriptively analyzed. Ethical approval was obtained. Result: There were 121 patients, male 82(67.8%) and female 38(31.4%) aging 14 to 90 years. Fifty-three patients (43.8 %) presented with hematemesis, 38(31.4%) with melena, and 27(22.3%) with both hematemesis and melena. Variceal bleeding was the main cause of upper gastrointestinal bleeding found in 73(60.33%) followed by ulcer bleeding in 48(39.66%). Conclusion: Variceal bleeding was the main cause of upper gastrointestinal bleeding and hematemesis was the most common clinical presentation in patients presenting to the Emergency Department.

Not so Goody’s powder

2021 ◽  
Vol 14 (7) ◽  
pp. e242055
Author(s):  
Raja Samir Khan ◽  
Sardar Momin Shah-Khan ◽  
Justin Kupec
Keyword(s):  
Peptic Ulcer ◽  
Adverse Effects ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Upper Gastrointestinal Bleeding ◽  
Gastrocolic Fistula ◽  
Over The Counter ◽  
Ulcer Disease ◽  
Upper Gastrointestinal ◽  
Acute Anaemia

Over-the-counter analgesic medications are widely used amongst American adults and are also available in powder forms. Their adverse effects have been well documented in literature. Gastrocolic fistulas as a complication of peptic ulcer disease from analgesic powder usage have been previously unreported. Here, we report a patient with upper gastrointestinal bleeding and acute anaemia secondary to peptic ulcer complicated by gastrocolic fistula in a patient using analgesic powder.

Tu1367 Comparison of Glasgow-Blatchford Score, Rockall Score, and AIMS65 Score for Predicting Upper Gastrointestinal Bleeding Outcomes in Korea

2016 ◽  
Vol 150 (4) ◽  
pp. S886
Author(s):  
Jung Wan Choe ◽  
Dongwon Lee ◽  
Seung Young Kim ◽  
Jong Jin Hyun ◽  
Sung Woo Jung ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Rockall Score ◽  
Upper Gastrointestinal

Risk Assessment of Patients with Non-Variceal Upper Gastrointestinal Bleeding Using the Rockall Score

2005 ◽  
Vol 61 (5) ◽  
pp. AB166
Author(s):  
Martin Hunstiger ◽  
Werner Schmidbaur ◽  
Juergen Barnert ◽  
Thomas Eberl ◽  
Reinhard Fleischmann ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Rockall Score ◽  
Upper Gastrointestinal
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