Endoscopy 2019; 51(04): S141
DOI: 10.1055/s-0039-1681585
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 13:00 – 13:30: GI bleeding 2 ePoster Podium 6
Georg Thieme Verlag KG Stuttgart · New York

ACUTE GASTROINTESTINAL BLEEDING IN THIRD WORLD COUNTRIES WITH FEW RESOURCES: A STUDY OF 1347 PATIENTS IN SPECIALIZED CENTRE

N Arabi Mohammad
1   Ibn Sina Specialized Hospital, Khartoum, Sudan
,
A Musaad
1   Ibn Sina Specialized Hospital, Khartoum, Sudan
,
E Ahmed
1   Ibn Sina Specialized Hospital, Khartoum, Sudan
,
MA Aziz
1   Ibn Sina Specialized Hospital, Khartoum, Sudan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

Acute gastrointestinal blood loss presents a management challenge and a crucial threat to the patients. The bleeding lesion cannot be easily controlled by endoscopy for unexperienced hand, but it is necessary for definitive diagnosis and management. The aim of this study is to reflect the causes, and management of acute gastrointestinal bleeding in Sudanese patients.

Methods:

It is cross sectional hospital based study, it included 1347 patients who presented to Mohamed saleh idris-bleeding centre, Ibn sina specialized hospital, Khartoum, Sudan, a specialized centre that receives 1900 – 2200 active gastrointestinal bleeding patients per year as an emergency, all patients were admitted, resuscitated and decision of endoscopy was made for all, data collected and analysed by SSPS.

Results:

Nearly 95% of patients had upper gastrointestinal bleeding, it is common in male and the mean age was 45 years. Oesophageal varices due to bilharzial portal hypertension was diagnosed in more than 90%, most of them had active bleeding. Sclerotherapy was used in the majority of them to stop bleeding, band ligation in 10.1%, both sclerotherapy and band ligation in only 1.8%. Sengestaken tube was used in 9.4%, approximately 9% had fundal varix and only 6% had both oesophageal and fundal varix, and few patients had ectopic duodenal varix, all of them were injected with N-butyl-2-cyanoacrylate (Histoacryl), while only 5.6% of the patients had ulcer and few patients had gastric malignancy. The most common cause of lower gastrointestinal bleeding was upper gastrointestinal bleeding followed by diverticular disease in 39.6%, colonic tumours 12.34%, inflammatory bowel disease 10.4%, angiodysplesia 4.5%, and the remaining were ischemic colitis, rectal varix and small bowel origin.

Conclusions:

Oesophageal varices and diverticular disease being the commonest causes of acute gastrointestinal bleeding. Sclerotherapy is cheap and beneficial in cessation of active oesophageal variceal bleeding, and N-butyl-2-cyanoacrylate is effective in gastric and duodenal varix.