Current Trends in Etiological Profile of Acute Upper Gastrointestinal Bleeding in Northern India: A Retrospective Analysis of 5-Year Endoscopic Data

Abstract

Introduction The etiological spectrum of acute upper gastrointestinal bleeding (AUGIB) varies from region to region. This study was performed to find out the latest etiological spectrum of the AUGIB in a tertiary care hospital in North India and to compare it with etiological spectra from a previous study from the same center and from the other regions of India. Methods Clinical notes and endoscopic data of all consecutive patients who had presented with AUGIB in Indira Gandhi Medical College Shimla, Himachal Pradesh, from May 2015 to December 2019, were analyzed retrospectively with the objective of finding out the various endoscopic etiologies that lead to AUGIB. The findings were compared with the previous study from the same center and with the data from the other regions of the country. Results A total of 1,513 patients were enrolled and majority were males (74.6%) with male:female ratio of 2.9:1. Majority were 41 to 60 years (46.46%) of age. Melena was the presenting complaint in 93.98% and hematemesis in 46.06%. Peptic ulcer disease (PUD; 46.19%) was the commonest cause of AUGIB followed by portal hypertension (26.23%). Other less common causes were erosive mucosal disease, erosive esophagitis, neoplasm, Mallory–Weiss tear, gastric angiodysplasia, anastomotic site ulcers, and Dieulafoy’s lesion. Conclusion PUD was still the commonest cause of AUGIB followed by portal hypertension. This is in agreement with the previous report from the same center and in contrast to the reports from other studies from Northern and Western India that create the impression that portal hypertension related bleeding is the most common cause of AUGIB in India.

Keywords

• acute upper gastrointestinal bleeding
• esophagogastroduodenoscopy
• portal hypertension
• peptic ulcer disease