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Abstract
Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency. Endoscopic therapy remains the mainstay for diagnosis and treatment of upper gastrointestinal bleeding. Despite the recent advances in endoscopic and medical therapy, overall mortality from UGIB (5%-15%) has not changed significantly over the past few decades and varies according to the age and comorbidity of the patient.
The aim of this work was to evaluate the different causes of upper G I T bleeding other than varices in cirrhotic patients attending Zagazig university hospitals from January 1st to 31 December 2004.
This study included 654 patients who presented with non variceal upper gastrointestinal bleeding . Based on clinical and sonographic criteria of cirrhosis, the entire enrolled patients were classified into the following groups (Freedman and Keefe, 2004)
• Group A :
Non cirrhotic with endoscopic findings of non variceal origin of upper gastrointestinal bleeding .
• Group B:
Cirrhotic patients with non variceal causes of upper gastrointestinal bleeding . Patients presented with upper gastrointestinal bleeding due to esophageal or gastric avarices were excluded ,they were 1418 cases.
All patients were subjected to; Immediate resuscitation, Clinical evaluation, laboratory investigations, Abdominal ultrasono graphy, Upper gastrointestinal endoscopy and Pathological examination of biopsies obtained from the mucosa of the body and antrum of the stomach from 50 patients of group B (cirrhotic) patients.
The main indication for performing upper gastrointestinal endoscopy in the entire studied patients was hematemesis and melena (88.07%) while a few had a history of melena(11.31%), while rare cases presented with hematemesis only (0.4%) .