Original Article

Analysis of 148 Cases with Upper Gastrointestinal Bleeding

10.5222/otd.2011.130

  • Murat Gençay
  • Osman Maviş
  • Rahime Özgür
  • Zeynep Taşkın Özsığınan
  • Gülay Arıcı

Received Date: 15.11.2010 Accepted Date: 06.01.2011 Eur Arc Med Res 2011;27(3):130-137

Objective:

Upper gastrointestinal bleeding is one of the most important causes of mortality and morbidity. We intended to investigate the characteristics of our cases with upper gastrointestinal bleeding.

Material and Methods:

148 cases with upper gastrointestinal system bleeding followed-up in our clinic between January 2005 and December 2008 were retrospectively evaluated. The patients were assessed as for age, gender, presenting complaints, previous drug and/or other therapies , bleeding episodes, laboratory , and endoscopic findings, need for transfusion, duration of hospitalization, concomitant diseases, smoking status, alcohol usage, and mortality.

Findings:

Study participants consisted of 106 (71,6 %) male and 42 (28,4 %) female patients with a mean age of 61.8±16.7 years, and 69.8 % of the patients had at least one additional disease. Complaints at admission included melena (56.1 %), hematemesis (10.1 %) or both (33.8 %). Eighty-nine (61 %) patients had history of medication. Among the patients 35 (23.6 %) were smokers, while 92 (62.2 %) of them were routinely using alcoholic beverages. The mean values for hemoglobin (8.8 g/dl) hematocrit (27.0 %), urea (76.9 mg/dl), and serum creatinine (1.1 mg/dl) levels were also recorded. The most common findings observed during upper gastrointestinal system endoscopy were duodenal ulcer (n= 51; 34.5 %), gastritis (n= 20; 13.5 %), variceal bleeding (n= 17; 11.5 %), and gastric ulcer (n=25; 9.5 %). The patients received only medical treatment (n=131) Band ligation (n=4), Sengstaken Blakemore tube intubation (n= 7), sclerotherapy (n=4) and surgical treatment (n= 7) were also performed. The mean hospital stay was 7.18 days, and 18 (16 %) patients over 60 years of age died during follow-up period.

Conclusion:

To reduce mortality in addition to providing control of bleeding, concomittant diseases should be treated carefully. Protective medications in patients using aspirin and NSAIDs should be added to the treatment. Elderly patients with additional diseases should be monitored in the intensive care unit.

Keywords: Gastrointestinal bleeding, duodenal ulcers, endoscopy, esophageal varices