Endoscopic Evaluation of Upper Gastrointestinal Bleeding in Patients Presenting with Hematemesis within 24 Hours of Admission

OBJECTIVE: To evaluate with endoscopy the common causes of upper gastrointestinal bleeding in patients presenting with hematemesis within 24 hours of admission. DESIGN: A cross sectional observational study. SETTING: Medical unit III, LUMHS Jamshoro. DURATION: Six months from 1st Jul, 2014 - 31st Dec, 2014. METHODS: One hundred cases of hematemesis were included in the study. Patients who refused endoscopy and those on NSAIDs, anticoagulants & steroids were excluded from study. Upper gastrointestinal endoscopy was performed within 24 hours of admission. RESULTS: Out of 100 patients selected, 51 (51%) were males and 49 (49%) females. Majority of patients were between 30-60 years with mean age of 43.97 years +/- SD 7.8. Variceal bleed was the most common cause n=54 (54%) followed by peptic ulcer disease (PUD) n=20 (20%). Esophagitis was noted in ten (10%) patients, gastric erosions in nine (9%), tumors of upper gastrointestinal tract in six (6%) and Mallory-Weiss tear was responsible in only one (1%) cases. CONCLUSION: Variceal bleeding secondary to portal hypertension is the most frequent cause of bleeding in upper gastrointestinal tract. Increased prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in this part of the world has resulted in increased incidence of liver cirrhosis and portal hypertension highlighting the importance of prevention of HBV and HCV.