Contribution of Gastroscopy in Non-Varicoseupper Gastro-Intestinal Bleeding and Predictive factors for the Need for Endoscopic Treatment : A Prospective Study

Authors : Addajou Tarik; Rokhsi Soukaina; Mrabti Samir; Benhamdane Ahlame; Sair Asmae; Touibi Abdelfettah; Mohamed Osman Guelleh; Berraida Rida; Elkoti Ilham; Rouibaa Fedoua; Benkirane Ahmed; Seddik Hassan

Volume/Issue : Volume 6 - 2021, Issue 11 - November

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Upper gastro intestinal bleeding (UGIB) remains a frequent cause of emergency hospitalisation in gastro enterology. Schematically, they are divided into varicose and non-varicose Upper gastro intestinal bleeding (NVUGIB), the latter being the most frequent will be the subject of our study. The aim of our study is to evaluate the contribution of gastroscopy in non-varicose HDH and to search for factors that predict the need for endoscopic haemostasis. Methods: This prospective monocentric cross-sectional study of 261 patients, was conducted over a one year period from June 2020 to August 2021 in the department of endoscopic emergency of Mohammed V Military Hospital, Rabat, Morocco. Result : The average age of our patients was 58 ±17 years,witha sex-ratio of 2.57. 28.7% of our patients had comorbidities, with 19.9% taking antithrombotic drugs. 91% of our patients received proton pump inhibitor (PPI) treatment with syringe pump before performing the endoscopy. The main findings at endoscopy were pepticulcer disease in 39% of cases, erosive gastritis or duoden it is in 30% of cases, and esophagit is in 15% of cases. Active bleeding during endoscopy was identified in 12% of cases, requiring endoscopic haemostas is in 6.5% of cases, however, surgery was necessary in 3 patients for bleeding not suitable for endoscopic haemostasis. In a multi variate analysis following adjustment of the study parameters, namely, age, gender, the presence of comorbidities, the use of PPI at syringe pump and the presence of active bleeding, only the presence of active bleeding and the use of PPI at syringe pump influenced the need for endoscopic haemostasis. In fact, the presence of active bleeding during endoscopy multiplies the risk of recourse to endoscopic haemostasis by 15, whereas the use of PPI with syringe pump seems to reduce this risk by 75%. Conclusion : NVUGIB remains dominated by ulcerative origin. According to our study PPI treatment initiated prior to endoscopy for upper gastrointestinal bleeding may reduce the proportion of patients with stigmata of recent haemorrhage and therefore reduces the need for haemostatic treatment.

Keywords : non-varicose Upper gastro intestinal bleeding, gastroscopy, endoscopic haemostasis, proton pump inhibitor.


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