Abstract

PALOMINO BESADA, Amada et al. Experiences in emergency endoscopy for upper gastrointestinal bleeding. Rev Cub Med Mil [online]. 1997, vol.26, n.2, pp.116-121. ISSN 0138-6557.

Patients affected by upper digestive bleeding were studied by emergency endoscopy during the period of the 1991-1993, with the aim of knowing the importance and the prognostic value of early endoscopy, mortality, lethality, surgical need, and the most frequent bleeding lesions. Of 662 emergencies performed, 4.6 % were patients with upper digestive bleeding and of them 61 % presented with peptic ulcer, 34 % with duodenal ulcers, and 26 % with gastric ulcers which constituted the most frequent diagnosed lesions. The overall lethality rate due to upper digestive bleeding was of 16 %; mortality was of 4.1 %, and bleeding as the primary cause of death in 3.9 % of cases. In patients presenting with bleeding ulcers, lethality was found to be of 9.9 %, and mortality of 1.5 %. The need to perform a surgical intervention in patients with bleeding was of 20.7 % and in patients presenting with ulcers was of 27.2 %. The average hospital stay was 14 days. The importance of performing an early endoscopy as diagnostic and prognostic method was evidenced in cases of upper digestive bleeding, but the procedure alone is not enough to reduce the mortality and lethality rates. The need for performing a therapeutic endoscopy was proved in these cases in order to achieved figures lower than 4 % of mortality.

Keywords : GASTROINTESTINAL HEMORRAGE [diagnosis]; GASTORINTESTINAL HEMORRAGE [mortality]; EMERGENCY MEDICAL SERVICES.