CONTRIBUTION OF GASTROSCOPY IN NON-VARICOSE UPPER GASTROINTESTINAL BLEEDING AND PREDICTIVE FACTORS FOR THE NEED FOR ENDOSCOPIC TREATMENT : A PROSPECTIVE STUDY

Aims The aim of our study is to evaluate the contribution of gastroscopy in non-varicose HDH and to assess the factors that predict the need for endoscopic haemostasis.

Methods This prospective monocentric cross-sectional study of 261 patients, was conducted over a one year period from June 2020 to August 2021 in the department of endoscopic emergency of our Hospital.

Results The average age of our patients was 58±17 years, with a sex-ratio of 2.57. 91% of our patients received proton pump inhibitor (PPI) treatment with syringe pump before performing the endoscopy.

The main findings at endoscopy were peptic ulcer disease in 39% of cases, erosive gastritis or duodenitis in 30% of cases, and esophagitis in 15% of cases

Active bleeding during endoscopy was identified in 12% of cases, requiring endoscopic haemostasis in 6.5% of cases, however, surgery was necessary in 3 patients for bleeding not suitable for endoscopic haemostasis.

In a multivariate analysis following adjustment of confounding factors, only the presence of active bleeding and the use of PPI at syringe pump influenced the need for endoscopic haemostasis. In fact, the presence of active bleeding during endoscopy multiplies the risk of recourse to endoscopic haemostasis by 15, whereas the use of PPI with syringe pump seems to reduce this risk by 75%.

Conclusions NVUGIB remains dominated by ulcerative origin. According to our study PPI treatment initiated prior to endoscopy for upper gastrointestinal bleeding may reduce the proportion of patients with stigmata of recent haemorrhage and therefore reduces the need for haemostatic treatment.

Publication History

Article published online:
14 April 2022