Endoscopic Evaluation among Patients Presenting with Upper Gastrointestinal Tract Bleeding

Abstract

Background: Bleeding from the upper gastrointestinal tract is a critical medical condition that requires prompt diagnosis and management. Endoscopic evaluation plays a pivotal role in identifying the source of bleeding, determining its severity, and guiding appropriate interventions. Objective: The objective of this study was to conduct a comprehensive endoscopic evaluation in patients who have presented with bleeding originating from the upper gastrointestinal tract. Study Design: Descriptive cross-sectional study. Settings: Department of Gastroenterology, Islamic International Medical College, Rawalpindi Pakistan. Duration: Study duration was 7 months from November 2021 to April 2022. Methods: Patients who were 18 years of age or older and presented with active or recent upper gastrointestinal bleeding, regardless of gender, and were scheduled for endoscopic examination, were incorporated into the study. Upper gastrointestinal endoscopies were performed. The procedure was involving the direct visualization of the esophagus, stomach, and duodenum using an endoscope. Any visible lesions or bleeding sources were documented. Data regarding the location and nature of bleeding sources and the endoscopic diagnosis were recorded in a standardized data collection form and analyzed by SPSS version 26. Results: The study included 59 patients with a mean age of 52.27 years. Esophageal endoscopic findings revealed "Grade I to III Esophageal varices (EV) being less common (3.4%, 11.9%, and 13.6% respectively). LAX LEs, esophagitis and Hiatus hernia were observed in 10.2%, 3.4%, and 6.8% of cases. Rarer findings, including Venules, Ecstatic vein, Candidiasis, and various combinations, each accounted for 1.7% of cases. Portal hypertension gastropathy was the most prevalent condition (20.3%), followed by Antral gastritis (45.8%), Erosive gastropathy (10.2%), and other less frequent conditions, such as fundal varices, GOVI varices, diffuse gastritis and Ulcer. Grade II and III EV, and PHTN gastropathy, were significantly more prevalent among males, while Antral gastritis was notably higher among females (p < 0.05). Although the endoscopic findings did not show any statistically significant differences based on gender (p > 0.05). Conclusion: PHTN gastropathy, antral gastritis, grade III EV and erosive gastropathy were the most common conditions among patients with Hematemesis, along with less frequent findings like grade I to III Esophageal varices, Venules, Ecstatic vein, Candidiasis, and combinations of these conditions.