A Study of Upper GI Endoscopy in a Rural Tertiary Care Centre of Pakistan.

Abstract

Objective: To determine the common indications, yield and findings of Upper Gastrointestinal Endoscopy(UGIE) in a rural setting of Pakistan.Patients and Methods: Retrospective analysis of the endoscopy data of all 772 patients who underwent UGIEin Muhammad Medical College Hospital between 1st August 2009 and 31st July 2011.Results: Out of the total of 772 patients, there were 398 men (51.5%). The average age was 41 years (range13 –92). Therapeutic endoscopies comprised 27.3% (n = 211) of all UGIEs. All 561 patients who underwent diagnostic procedure were given choice to have UGIE done either under sedation or with pharyngeal anaesthesia only.Vast majority (n = 525; 93.5%) preferred sedation with Midazolam (mean dose 3 mg). Commonest indication forUGIE was acute upper gastrointestinal bleed (AUGIB) (n = 275; 35.6%), followed by dysphagia (n = 136; 17.6%)and upper abdominal pain (n = 126; 16.3%). The commonest finding was normal examination (n = 271; 35.1%),oesophageal varices (n = 206 [26.6%] – bleeding = 147, non-bleeding = 59;), carcinoma of oesophagus (n = 51;6.6%), portal hypertensive gastropathy (n = 50; 6.4%) and peptic ulcer disease (n = 46; 6.2%). Commonest therapeutic procedure performed was endoscopic treatment of oesophageal varices (n = 182). No immediate complication was seen.Conclusion: In our setting, UGIE is a common and safe procedure. 93.5% patients would like to have a diagnostic UGIE done under sedation. AUGIB constitutes over 1/3 of all UGIE indications and oesophageal varices arethe commonest abnormal findings, requiring endoscopic treatment.