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Acute upper gastrointestinal bleeding: Pattern of presentation and aetiology in a Tertiary Hospital in South-West Nigeria
Abstract
Background: Acute Upper Gastrointestinal Bleeding (UGIB) is an important cause of morbidity and mortality worldwide. Peptic ulcer accounts for about 50%. However, a study from the USA reported a decline in peptic ulcer perforation and bleeding. The aim was to evaluate the pattern of presentation and the aetiology of acute upper gastrointestinal bleeding among Nigerian patients.
Methods: This study was carried out at the Medical Unit of the University College Hospital, Ibadan. Consecutive patients with any or all of haematemesis, melaena or haematochezia were recruited for the study. Demographic data, clinical presentation, history of NSAIDs ingestion, presence of other comorbid conditions were among the information gathered from each patient. The patients were stabilized haemodynamically, after which endoscopy was performed as soon as possible. The data were analyzed using the SPSS statistical software version 15.
Results: There were 123 patients, 96 (78.1%) males and 27 (21.9%) females with a mean age of 47.6±18.0 years (13 - 89 years). Abdominal pain was observed in 72 (58.5%) patients. Haematemesis alone was present in 15 (12.2%), while 29 (23.6%) presented with melaena. Four (3.2%) had haematochezia, while 75 (61%) had both haematemesis and melaena. Dizziness was seen in 82 (66.7%) patients, while 43 (35%) had syncope. The aetiologies are: gastric erosion (56.1%), duodenal ulcer (10.6%), oesophageal varices (7.3%), gastric ulcer (6.5%), gastric angiodysplasia (0.8%). No abnormality was seen in 3 (2.4%) patients.
Conclusion: In this study combination of haematemesis and melaena was the commonest presentation and the commonest aetiology was gastric erosion.
Keywords: Upper gastrointestinal bleeding, Presentation, Aetiology, Tertiary hospital, Nigeria
Methods: This study was carried out at the Medical Unit of the University College Hospital, Ibadan. Consecutive patients with any or all of haematemesis, melaena or haematochezia were recruited for the study. Demographic data, clinical presentation, history of NSAIDs ingestion, presence of other comorbid conditions were among the information gathered from each patient. The patients were stabilized haemodynamically, after which endoscopy was performed as soon as possible. The data were analyzed using the SPSS statistical software version 15.
Results: There were 123 patients, 96 (78.1%) males and 27 (21.9%) females with a mean age of 47.6±18.0 years (13 - 89 years). Abdominal pain was observed in 72 (58.5%) patients. Haematemesis alone was present in 15 (12.2%), while 29 (23.6%) presented with melaena. Four (3.2%) had haematochezia, while 75 (61%) had both haematemesis and melaena. Dizziness was seen in 82 (66.7%) patients, while 43 (35%) had syncope. The aetiologies are: gastric erosion (56.1%), duodenal ulcer (10.6%), oesophageal varices (7.3%), gastric ulcer (6.5%), gastric angiodysplasia (0.8%). No abnormality was seen in 3 (2.4%) patients.
Conclusion: In this study combination of haematemesis and melaena was the commonest presentation and the commonest aetiology was gastric erosion.
Keywords: Upper gastrointestinal bleeding, Presentation, Aetiology, Tertiary hospital, Nigeria
