Outcomes of On-Site Emergency Endoscopy in Non-Transportable Patients with Gastrointestinal Bleeding

Aims Gastrointestinal bleeding poses a significant global health challenge, with a substantial proportion originating from the upper gastrointestinal (GI) tract. In Mongolia, the vast territory, and long distances between cities present challenges in providing endoscopic care to patients who cannot be transported. This study aims to evaluate the outcomes of on-site emergency endoscopy in non-transportable patients with GI bleeding.

Methods Our team has attended to a total of 810 cases requiring emergency endoscopic care, including bleeding, foreign bodies, and diagnoses, in 15 provinces and 6 districts since 2019. The distribution of cases based on the location of bleeding and associated conditions was analyzed.

Results Among the emergency cases, 79% presented with upper GI bleeding, while 13% involved bleeding in the lower GI tract. Esophageal varices accounted for 64% of the bleeding cases, followed by varices in the fundal stomach (11%) and stomach ulcers (21%). Within 48 hours, 10 deaths were recorded, resulting in a mortality rate of 2.1% (15/691).

Conclusions Timely intervention and early detection of bleeding symptoms significantly improved intensive care outcomes and reduced costs. The success rate of endoscopic detection and control of gastrointestinal bleeding was 96-98%, underscoring the importance of accurate clinical evaluation and early diagnosis in emergency scenarios. We recommend establishing a National Unified Network for remote assistance and conducting accurate statistical research with state investment. It is crucial to precisely determine the indications for intensive care and on-call endoscopic care, aligning them with time-related guidelines that correspond to the clinical course of the disease. Furthermore, ensuring discounts for high costs, irrespective of hospital hierarchy, would further enhance accessibility to essential care.

Keywords: gastrointestinal bleeding, emergency endoscopy, on-site care, non-transportable patients, outcomes.

Publication History

Article published online:
27 March 2025