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. 2021 Jan-Feb;27(1):28-34.
doi: 10.4103/sjg.SJG_378_20.

Time trends of causes of upper gastrointestinal bleeding and endoscopic findings

Ibrahim M Alruzug  1 , Thamer A Aldarsouny  1 , Toufic Semaan  1 , Manhal K Aldaher  1 , Adnan AlMustafa  1 , Nahla Azzam  2 , Abdulrahman Aljebreen  2 , Majid A Almadi  3
Affiliations

Time trends of causes of upper gastrointestinal bleeding and endoscopic findings

Ibrahim M Alruzug et al. Saudi J Gastroenterol. 2021 Jan-Feb.

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a frequent cause for emergency endoscopy and, in a proportion, requires the application of endotherapy. We aim to evaluate the proportion of variceal and nonvariceal upper gastrointestinal bleeding (NVUGIB), the endoscopic findings that were detected, as well as the temporal trends of endoscopic findings over a period of 13 years.

Methods: This is a retrospective study of patients who underwent an esophagogastroduodenoscopy with an indication of UGIB or presented with hematemesis, melena, or both, as well as those who had hematochezia, from January 2004 to December 2016 (13 years).

Results: A total of 2075 patients were included with a mean age of 56.8 years (range 18-113) and males constituted 67.9%, while 65.9% had at least one comorbidity. Symptoms on presentation included hematemesis (52.5%), melena (31.2%), both hematemesis & melena (15.1%), and hematochezia (1.2%). The majority of UGIB were from a NVUGIB source (80.5%) and a variceal source was found in 13.1%, while no endoscopic findings were found in 6.4% of cases. The most common endoscopic diagnosis was gastroduodenal erosions (23.8%), duodenal ulcers (23.5%), reflux esophagitis (16.0%), esophageal varices (12.1%), and gastric ulcers (10.8%). There was no change in the endoscopic findings over the time period of the study. A third of duodenal ulcers (33.3%) as well as 21.9% of gastric ulcers were actively bleeding at the time of endoscopy, while 3.3% of duodenal ulcers had an adherent clot.

Conclusions: NVUGIB composed the majority of cases presenting with UGIB and variceal bleeding was lower than that described in prior studies, but there were no clear trends in the proportion of causes of UGIB during the study duration.

Keywords: Nonvariceal bleeding; Saudi Arabia; peptic ulcer disease; upper gastrointestinal bleeding; variceal bleeding.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Age of those who presented with upper gastrointestinal bleeding by sex
Figure 2
Figure 2
Age of those who presented with upper gastrointestinal bleeding by presenting symptom
Figure 3
Figure 3
Age comparison between those with a variceal compared to a nonvariceal source of bleeding
Figure 4
Figure 4
Endoscopic findings in relationship with presenting symptoms
Figure 5
Figure 5
(a). Stigmata found in duodenal ulcers. (b). Stigmata found in gastric ulcers
Figure 6
Figure 6
(a). Time trends comparing variceal and nonvariceal source of upper gastrointestinal bleeding. (b). Time trends comparing different endoscopic diagnoses of upper gastrointestinal bleeding
See this image and copyright information in PMC

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