Upper gastro-intestinal bleeding in Erbil Governorate

Abstract EN

Objectives : To define the aetiology, management, and outcome of upper gastro-intestinal bleeding, and to assess the role of endoscopy in the management.

Also to assess the factors to improve the management of this problem in this region.

Patients & methods : A prospective study of 102 patients admitted to the main hospitals under the care of the author (1999-2006).

Patients were assessed, resuscitated, and investigated by the standard methods.

All were endoscoped by the author (OGD).

Fifty patients were treated surgically, by laparotomy and according to the findings ; mainly under running suturing of bleeding duodenal ulcers.

Analysis of the causes, type and source of bleeding, indications of surgery, and the role of endoscopy was done.

Results : Total number of patients was 102, ninety males (88.2 %), and 12 females (11.8 %).

Age range was (8-68 years), with peak incidence at the fourth decade.

All patients were admitted to hospital, and received blood (2-18 units).

Melena was found in 22 patients (2 1.5 %).

History of aspirin and NSAID ingestion was found in 18 patients (17.6 %).

All patients were endoscoped during day working hours.

Causes of bleeding were : Chronic d.u.

in 60 patients (58.8 %) oesophageal varices in 15 patients (14.7 %), and no source of bleeding could be detected in 7 patients (6.8 %).

Fifty patients needed surgery (laparotomy) ; active bleeding vessel was the main pathology, present in 20 cases (40 %).

Fifty two patients were managed successfully on conservative treatment.

Conclusion: The most common cause of upper g.i.t.

bleeding in Erbil is bleeding duodenal ulcer, followed by oesophageal varices.

Gastroscopy proved to be a reliable and accurate method for diagnosis and treatment.

Lack of facilities for therapeutic endoscopy and intensive care, led to a high percentage of surgical treatment in about 50 % of patients.

Improvement of health infrastructure is essential to achieve a better care for our patients.