Clinical Profile and Endoscopic Spectrum of Upper Gastrointestinal Bleeding at a Tertiary Care Centre.

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a common medical emergency associated with considerable morbidity and mortality despite advances in endoscopic and medical management. Understanding its clinical profile and endoscopic spectrum is essential for timely diagnosis and effective treatment.

Methods: This hospital-based observational study included 100 consecutive adult patients presenting with UGIB at a tertiary care centre. Demographic characteristics, clinical presentation, laboratory findings, endoscopic diagnoses, therapeutic interventions, and in-hospital outcomes were recorded and analysed using appropriate statistical methods.

Results: The mean age of the patients was 54.82 ± 15.64 years, and 72% were males. Chronic liver disease (38%) was the most common comorbidity. Haematemesis (38%) was the commonest presenting symptom, while pallor (71%) was the most frequent clinical finding. Endoscopy identified oesophageal varices (31%) as the leading cause of UGIB, followed by duodenal ulcer (22%) and erosive gastritis (13%). Therapeutic endoscopy was performed in 61% of patients, with variceal band ligation being the most common intervention (29%). Blood transfusion was required in 68% of patients. Variceal bleeding was significantly associated with alcohol consumption, chronic liver disease, shock at presentation, higher INR, increased blood transfusion requirements, and therapeutic endoscopic intervention (all p<0.05). The mean hospital stay was 6.82 ± 3.41 days, and in-hospital mortality was 6%.

Conclusion: Variceal bleeding was the predominant cause of UGIB and was associated with greater clinical severity than non-variceal bleeding. Early resuscitation, prompt endoscopic evaluation, and timely therapeutic intervention are essential for improving patient outcomes.