Endoscopic Findings in Upper Gastrointestinal Bleeding at Lacor Hospital in Gulu, Northern Uganda

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a common emergency medical condition that may require hospitalization and resuscitation, and results in high patient morbidity. Upper gastrointestinal endoscopy is the preferred investigative procedure for UGIB because of its accuracy, low rate of complication, and its potential for therapeutic interventions. Therefore the aim of this study was to determine the endoscopic findings in patients presenting with UGIB and its frequency among these patients according to gender and age in Lacor Hospital, Northern Uganda.
Methods: The study was carried out at Lacor Hospital, located at Northern part of Uganda. The record of 224 patients who underwent endoscopy for upper gastrointestinal bleeding over a period of 5 years between January 2006 and December 2010 were retrospectively analyzed.
Results: A total of 224 patients had endoscopy for UGIB which consisted of 113 (50.4%) males and 111 (49.6%) females, and the mean age was 42 years ± SD 15.88. The commonest cause of UGIB was Esophageal varices consisting of 40.6%, followed by Esophagitis (14.7%), Gastritis (12.6%) and Peptic ulcer disease (duodenal and gastric ulcers) was 6.2%. The malignant conditions (Gastric and Esophageal cancers) contributed to 2.6%. Other less frequent causes of UGIB were Hiatus hernia (1.8), Duodenitis (0.9%), others-gastric polyp (0.4%). Normal endoscopic finding was 16.1% in patients who had UGIB.
Conclusions: Oesophageal varices are the commonest cause of upper gastrointestinal bleeding in this environment due to the high endemic nature of Hepatitis B infection among the population in Northern Uganda with nearly equal proportion of males to females as compared to the west which is mainly peptic ulcer disease.