Etiological and endoscopic profile in patients with non-variceal ugi bleed attending a tertiary care centre

Introduction: Non-variceal upper gastrointestinal bleeding (UGIB) is a common medical emergency associated with significant morbidity and mortality. At present, there is limited epidemiological data on non-variceal UGIB in India.
Aim: To study the etiological spectrum of non-variceal UGIB in our tertiary care centre.
Methodology: This is a retrospective trial. The registry of the endoscopies performed in the Institute of Medical Gastroenterology, Madras Medical College, Chennai, from December 2015 to December 2018, was referred to. Consecutive patients aged more than 13 years old with non-variceal UGI bleeds were included in the study. Endoscopy findings were documented in detail, along with the patient's age, sex and the presenting symptom of GI bleeding (hematemesis, melena, hematochezia). The data was analyzed to look for the most common lesions encountered during endoscopy in patients with non- variceal UGIB. The results are depicted in the form of tables and charts.
Results: In our study, 2582 patients were included. 922 patients (35.71%) were diagnosed with erosions in the esophagus, the stomach or the duodenum. This was the most common cause of non-variceal UGIB in our centre. 698 patients (27.03% ) had peptic ulcers (gastric or duodenal) as the cause of UGIB, 281 patients (10.88%) had Mallory- weiss tears, 104 patients (4.02%) had carcinomas (esophageal, gastric, duodenal, periampullary), 1 (0.04%) had an aorto-enteric fistula, 51 (1.98%) had GAVE, 30 (1.16%) had bleeding polyps in the stomach, 2 (0.07%) had Dieulafoy’s lesion, 125 (4.84%) had severe portal hypertensive gastropathy/duodenopathy, 20 (0.77%) had post EVL ulcer, 1 (0.04%) had Cameron’s lesion, 3 (0.11%) had hemosuccus-pancreaticus, 10 (0.38%) had anastomotic ulcers, 334 (12.97%) had no lesions on esophagogastroduodenoscopy.
Discussion And Conclusion: Our study shows that erosive disease of UGI were the most common cause of non- variceal UGIB (35.71%), whereas in most of the studies, it is peptic ulcer disease.