Etiological Spectrum, Clinical Profile and Prognostic Factors in Variceal Upper Gastrointestinal Bleeding

Background: Acute UGI bleed is defined as bleed occurring proximally to ligament of trietz and it is a common emergency presentation accounting for mortality rate of 10%. Worldwide, peptic ulcer disease is the commonest cause. Variceal bleeding has 30% in-hospital mortality and 60% mortality in the 1^st year. Material and Methods: 2-year prospective observational study was performed on 201 patients presenting with hemetemesis. Out of 201 patients, 125 (62.4%) patients were having varices and 76 (37.6%) had no varices. The patients with non-variceal bleed were excluded. Detailed history, examination and laboratory tests were performed. Appropriate statistical analysis on the data was performed. Results: Mean age of the variceal population was 44.9 years. Alcoholic cirrhosis (38%) was the commonest cause in variceal. Patients at presentation having tachycardia and hypotension had significantly increased risk of mortality both in variceal. Patients requiring endoscopic intervention had significantly increased mortality. Conclusion: We found variceal bleed to be the commonest cause of hemetemesis. Mean age of the vaiceal bleed patients was 5th decade. We observed alcoholic cirrhosis as the commonest cause of variceal bleed and alcohol as of cirrhosis. Tachycardia and hypotension on presentation and those requiring endoscopic intervention have poor prognosis.

Keywords: Acute upper gastrointestinal bleeding; Variceal bleeding; Hematemesis; Cirrhosis; Portal hypertension; Mortality; Peptic ulcer disease.