Aetiology Of Upper Gastrointestinal Bleeding In North-Eastern Nigeria: A Retrospective Endoscopic Study

Abstract

BACKGROUND: Acute upper gastrointestinal bleeding (UGIB) is a common life threatening emergency resulting in a large number of hospital admissions. Endoscopy done within the first 24 hours of bleeding has been shown to be the most reliable means of establishing the source of upper gastrointestinal haemorrhage. AIMS AND OBJECTIVES: The aim of this study is to determine the causes and outcome of patients with UGIB presenting at two tertiary hospitals in north-eastern Nigeria. MATERIALS AND METHODS : The study was carried out at the University of Maiduguri Teaching Hospital and the Federal Medical Centre Gombe, both located in north-eastern Nigeria. The records of 106 patients who underwent endoscopy for upper GI bleeding over a period of 6 years (2003-2008) were retrospectively analysed. RESULTS: A total of 106 patients were studied. Seventy-four (69.8%) were males while 32 (30.2%) were females. Their ages ranged from 14 to 75 years with a mean of 41.2 (±15.1SD) years. Oesophageal varices were the most frequent cause of bleeding (45.3%) followed by erosive mucosal disease (23.7%) and peptic ulcer disease (16.9%). Gastric cancer and Mallory-Weiss syndrome were rare with each accounting for 1.9% of the cases. In 11 (10.4%) patients no source of bleeding could be identified.Nineteen patients died giving a mortality rate of 17.9%. All the mortalities were recorded among those with variceal bleeding. CONCLUSION: Oesophageal varices are the commonest cause of upper gastrointestinal bleeding in this environment and responsible for most the mortalities associated with this condition.