A Fibreoptic endoscopic study of upper gastrointestinal bleeding at Bugando Medical Centre in northwestern Tanzania: A retrospective review of 240 cases

Autor: Mabula D Mchembe, Anthony C. Liwa, Eliasa Mkongo, Wolfgang Scheppach, Rodrick Kabangila, Phillipo L Chalya, Mariam M. Mirambo, Hyasinta Jaka, Mheta Koy
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
Blood transfusion
medicine.medical_treatment
lcsh:Medicine
HIV Infections
Tanzania
Risk Factors
Fiber Optic Technology
Endoscopy
Digestive System
Young adult
Child
lcsh:QH301-705.5
Medicine(all)
Aged
80 and over
Academic Medical Centers
medicine.diagnostic_test
Clinical outcome
Anti-Inflammatory Agents
Non-Steroidal
Smoking
Hematemesis
General Medicine
Middle Aged
Management
Fibreoptic endoscopy
Community Health
medicine.symptom
Gastrointestinal Hemorrhage
Adult
Aetiological spectrum
medicine.medical_specialty
Peptic Ulcer
Adolescent
Alcohol Drinking
Peptic
Short Report
Clinical profile
Esophageal and Gastric Varices
Sensitivity and Specificity
General Biochemistry
Genetics and Molecular Biology
Young Adult
Sex Factors
Melena
medicine
Humans
lcsh:Science (General)
Upper gastrointestinal bleeding
Aged
Retrospective Studies
business.industry
Biochemistry
Genetics and Molecular Biology(all)
lcsh:R
Infant
Retrospective cohort study
medicine.disease
Surgery
Endoscopy
lcsh:Biology (General)
Varices
business
lcsh:Q1-390
Zdroj: BMC Research Notes, Vol 5, Iss 1, p 200 (2012)
BMC Research Notes
ISSN: 1756-0500
Popis: Background Upper gastrointestinal (GI) bleeding is recognized as a common and potentially life-threatening abdominal emergency that needs a prompt assessment and aggressive emergency treatment. A retrospective study was undertaken at Bugando Medical Centre in northwestern Tanzania between March 2010 and September 2011 to describe our own experiences with fibreoptic upper GI endoscopy in the management of patients with upper gastrointestinal bleeding in our setting and compare our results with those from other centers in the world. Findings A total of 240 patients representing 18.7% of all patients (i.e. 1292) who had fibreoptic upper GI endoscopy during the study period were studied. Males outnumbered female by a ratio of 2.1:1. Their median age was 37 years and most of patients (60.0%) were aged 40 years and below. The vast majority of the patients (80.4%) presented with haematemesis alone followed by malaena alone in 9.2% of cases. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking prior to the onset of bleeding was recorded in 7.9%, 51.7% and 38.3% of cases respectively. Previous history of peptic ulcer disease was reported in 22(9.2%) patients. Nine (3.8%) patients were HIV positive. The source of bleeding was accurately identified in 97.7% of patients. Diagnostic accuracy was greater within the first 24 h of the bleeding onset, and in the presence of haematemesis. Oesophageal varices were the most frequent cause of upper GI bleeding (51.3%) followed by peptic ulcers in 25.0% of cases. The majority of patients (60.8%) were treated conservatively. Endoscopic and surgical treatments were performed in 30.8% and 5.8% of cases respectively. 140 (58.3%) patients received blood transfusion. The median length of hospitalization was 8 days and it was significantly longer in patients who underwent surgical treatment and those with higher Rockall scores (P 60 years and in patients with higher Rockall scores and those who underwent surgery (P Conclusion Oesophageal varices are the commonest cause of upper gastrointestinal bleeding in our environment and it is associated with high morbidity and mortality. The diagnostic accuracy of fibreoptic endoscopy was related to the time interval between the onset of bleeding and endoscopy. Therefore, it is recommended that early endoscopy should be performed within 24 h of the onset of bleeding.
Databáze: OpenAIRE
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