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
Google Scholar :
http://bitly.ws/gu88
Scribd :
https://bit.ly/3EYUIgA
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.