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Aetiology and other features of a cohort of adult Sri Lankans presenting with upper gastrointestinal bleeding (UGIB)

Authors:

RL Satarasinghe ,

Sri Jayewardenepura General Hospital, (Postgraduate Tertiary and Teaching), Kotte, LK
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AP De Silva,

Sri Jayewardenepura General Hospital, (Postgraduate Tertiary and Teaching), Kotte, LK
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K Arulnithy,

Sri Jayewardenepura General Hospital, (Postgraduate Tertiary and Teaching), Kotte, LK
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PD Abeyratne,

Sri Jayewardenepura General Hospital, (Postgraduate Tertiary and Teaching), Kotte, LK
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MAR Jayawardana

Sri Jayewardenepura General Hospital, (Postgraduate Tertiary and Teaching), Kotte, LK
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Abstract

Objectives: To ascertain major causes of UGIB and other related clinical features of adult Sri Lankan using open access endoscopy facilities.

Design and setting: 1500 upper gastrointestinal endoscopies performed by Ward-06, Sri Jayewardenepura General Hospital, Kotte from 01/03/2002 to 01/03/2004 for whatever reason was retrospectively reviewed. Those who had endoscopy for UGIB were selected for the study, and their endoscopy findings and other clinical features analysed.

Results: There were 342 (24%) upper GI bleeders. The mean age of presentation was 55.5 years +/-14.4 SD. A high proportion was seen between 50-70 years of age. Sex distribution was, male:female = 229:114 (2:1). 45% have presented with haematemesis, 31% with malaena, and 24% with both. Endoscopy showed the presence of severe antral gastritis and duodenitis, oesophageal varices, oesaphagitis, erosive gastropathy, portal hypertensive gastropathy, pangastritis and peptic ulcer disease in 38%, 35%, 28%, 28%, 20%, 17% and 15% of the instances respectively. Hiatus herniae were seen in 43% although its role was unclear. Often combined pathologies were seen. Only 52% of the varices showed endoscopic evidence of bleeding. Excess alcohol consumption was seen in 36% while 5% were on NSAIDs. 5% had endoscopic negatives.

Conclusions: UGIB is a major problem to the endoscopist, constituting about 25% of the work load, in this part of the continent. Although approximately 50% of the varices found had bled, portal hypertension related pathologies are a cause for concern. Alcohol was a contributory factor in 1/3 of the endoscoped population. Bleeding from PUD was not a dominant feature compared to the west.

DOI: http://dx.doi.org/10.4038/jccp.v41i2.3766

Journal of the Ceylon College of Physicians, 2010, 41, 57-60

Keywords: UGIB 
How to Cite: Satarasinghe, R. et al., (2011). Aetiology and other features of a cohort of adult Sri Lankans presenting with upper gastrointestinal bleeding (UGIB). Journal of the Ceylon College of Physicians. 41(2), pp.57–60. DOI: http://doi.org/10.4038/jccp.v41i2.3766
Published on 02 Nov 2011.
Peer Reviewed

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