Abstract
Gastrointestinal (GI) bleeding has created an increasing demand for medical and surgical care; in addition, It is potentially serious and considered life-threatening in all age groups. This prospective study aims to find out the most common causes of GI bleedings, the incidence, the mode of treatment, and to investigate whether a simplified clinical score was able to predict the level of severity in the emergency department. About 170 patients aged (19 – 73) years who had been admitted to the emergency department in Baghdad teaching hospital were prospectively evaluated according to the causes of GI bleeding they presented with, the mode of treatment, and the degree of severity. Out of 170 patients included in this study, 95 patients (55.88%) were males, and 75 patients (44.12%) were females, with an average age of 41.11 years. The causes of GI bleeding were peptic ulcer (29.41%), gastritis (18.82%), diverticulitis (8.82%), hemorrhoids (8.23%), colonic cancer (7.64%), inflammatory bowel diseases (7.64%), anal fissure (7.05%), mesenteric ischemia (7.05%) and oesophagal varices (5.29%). Most of the cases of a peptic ulcer due to duodenal ulcer. Diagnostic endoscopy and conservative management were the main modes of treatment in these patients. Peptic ulcer and gastritis appear to be the main causes of GI bleeding, especially upper GI bleeding, while diverticulitis seems to be the main cause of lower GI bleeding and can be managed conservatively. Haemorrhoids and anal fissures will be managed surgically, either elective or emergency surgery. Also, our simplified clinical score appeared to be associated with the detection of the level of severity, which may deserve urgent interventions.
Highlights
GI bleeding is among the most common medical emergency
The main causes of GI bleeding in this study were peptic ulcer (29.41%), gastritis (18.82%), diverticulitis (8.82%), haemorrhoids (8.23%), colonic cancer (7.64%), inflammatory bowel diseases (7.64%), anal fissure (7.05%), mesenteric ischemia (7.05%), and oesophagal varices (5.29%)
This study showed that duodenal ulcer is the most common cause of peptic ulcer diseases about 32 (64%) patients among 50 patients complained from a duodenal ulcer which was diagnosed by emergency diagnostic endoscopy and showed that higher male incidence about 18 (56.25%) male patients among 32 patients
Summary
GI bleeding is among the most common medical emergency. It is an abnormal condition in which there is a coffee ground vomiting (hematemesis), from the throat, from the rectum (hematochezia), or blood tarry stool (melena); it is a symptom of many diseases rather than a disease itself. Several different conditions can cause gastrointestinal bleeding, and some of these causes may be life-threatening. Most of these conditions can be healed or managed. Finding the source of the bleed is essential; knowing if the bleeding is coming from the upper or lower digestive tracts can help to make the diagnosis and know the mode of treatment. Finding the source of the bleed is essential; knowing if the bleeding is coming from the upper or lower digestive tracts can help to make the diagnosis and know the mode of treatment. [1]
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