The Role of Endoscopy in the Diagnosis and Management of Upper Gastrointestinal Bleeding.

ABSTRACT

Background: Upper gastrointestinal bleeding is a common medical and surgical emergency. The aim of the study is to comprehend the aetiology of upper gastrointestinal bleeding by endoscopy and to evaluate the different endoscopic modalities for the management of upper gastrointestinal bleed. Methods: In 117 haemo-dynamically stable patients with the history of upper gastro-intestinal bleed endoscopy was done and possible site and cause of bleeding determined .The bleeding was stopped using one or more of the undermentioned modalities- Endoscopic Sclerotherapy (ES) using absolute alcohol, Endoscopic Varicael ligation (EVL), Injection Epinephrine (1100,000) Results: Out of 84 patients bleeding was stopped in 81(96.42%) by endoscopic intervention. Among 72 (85.71%) patients of oesophageal varices treated with ES, re-bleed occurred in 2 (2.38%) patients. While out of 12 (14.28%) non variceal patients, rebleed occurred in 1 (8.30%) patient. Conclusion: Most of the upper gastrointestinal bleed patients who presented in our setup were having varices. On the basis of lower rates of re-bleeding, mortality, complications and need for fewer endoscopic treatments, ligation should be considered as the endoscopic treatment of choice for patients with oesophageal variceal bleeding.