doiSerbia

Upper gastrointestinal bleeding: Five-year experience from one centre

Jovanović Ivan (Klinika za gastroenterologiju i hepatologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Popović Dragan (Klinika za gastroenterologiju i hepatologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Đuranović Srđan (Klinika za gastroenterologiju i hepatologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Pavlović Aleksandra (Klinika za gastroenterologiju i hepatologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Mijalković Nenad (Klinika za gastroenterologiju i hepatologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Krstić Miodrag (Klinika za gastroenterologiju i hepatologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)

Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal (GI) bleeding as well as its relation to age, gender and known risk factors. METHOD We conducted retrospective observational analysis of emergency endoscopy reports from the records of the Emergency Department of Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, during the period from 2000 to 2005. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the period 2000-2005, three thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases, acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicylates and NSAIDs. In most of the examined cases, bleeding stopped spontaneously, while 7.6% of the cases required endoscopic intervention. Duodenal ulcer was detected as a source of bleeding in 1320 (33.4%) patients and was significantly associated with a male gender (71.8%) and salicylate or NSAID abuse (59.1%) (χ2-test; p=0.007). Conclusion Erosive gastropathy and duodenal ulcer represent a significant cause of upper gastrointestinal bleeding accounting for up to 60% of all cases that required emergency endoscopy during the 5- year period. Consumption of NSAIDs and salicylates was associated more frequently with bleeding from a duodenal ulcer than with erosive gastropathy leading to a conclusion that we must explore other causes of erosive gastropathy more thoroughly. .

Keywords: gastrointestinal (GI) bleeding, erosive gastropathy, duodenal ulcer