Main Article Content

Muhammad Ayaz
Muhammad Daud Khalil
Salman Khan
Gul Ghutai
Hafsa Parveen
Sami Ullah


Gastrointestinal, Bleeding, Endoscopy, Pakistan


Background: Acute upper gastrointestinal bleeding (AUGIB) continues to be a major global health emergency that affects millions of people each year, placing a heavy strain on healthcare systems and presenting a serious risk to patient safety.

Objective: This study's main goal was to thoroughly evaluate the endoscopic results in Pakistani patients who were presenting with AUGIB.

Methodology: The research was conducted from 01 June 2023 to 30 November 2023 at the Department of Gastroenterology, MTI MMC Mardan, Pakistan, using a retrospective observational approach. Upper Gastrointestinal endoscopy (OGD) was the main diagnostic method used in patient evaluations, which also included comprehensive physical exams, blood testing, viral hepatitis serology, and abdominal ultrasounds. OGD results were methodically recorded. Age, gender, hepatitis status, and endoscopic results were all included in the data analysis, which was done using SPSS.

Results: In our investigation of 162 patients with Upper Gastrointestinal Bleeding (UGIB), endoscopic results showed differing frequencies of infection: 59.26% (n=96) of patients had Hepatitis C Virus and 25.93% (n= 42) had Hepatitis B Virus, 89.51% (n=145) had Oesophageal Varices, and 14.81% (n=24) had Peptic Ulcer Disease. Oesophageal varices showed significant gender-based disparities, with 39 female patients (26.90%) and 106 male patients (73.10%) (p-value=0.002). There were significant differences (p-value=0.004) in the gastric variations between 26 male patients (54.17%) and 22 female patients (45.83%).

Conclusion: Hepatitis C Virus (HCV) emerges as the leading cause of AUGIB in Pakistan, and esophageal varices dominate endoscopic findings in 89.51% of cases.

Abstract 216 | pdf Downloads 100


1. Rattanasupar A, Chang A, Akarapatima K, Chaojin T, Piratvisuth T. Role of lactulose for prophylaxis against hepatic encephalopathy in cirrhotic patients with upper gastrointestinal bleeding: A randomized trial. Indian Journal of Gastroenterology. 2021 Dec;40(6):621-9.
2. Nightingale NM. Investigating Haemoglobin Thresholds for Red Blood Cell Transfusion in Patients with Acute Upper GI Bleeding (Doctoral dissertation, The University of Western Ontario (Canada)).
3. Gralnek IM, Dumonceau JM, Kuipers EJ, Lanas A, Sanders DS, Kurien M, Rotondano G, Hucl T, Dinis-Ribeiro M, Marmo R, Racz I. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015 Oct;47(10):a1-46.
4. Nelms DW, Pelaez CA. The acute upper gastrointestinal bleed. Surgical Clinics. 2018 Oct 1;98(5):1047-57.
5. Orpen-Palmer J, Stanley AJ. Update on the management of upper gastrointestinal bleeding. BMJ medicine. 2022;1(1).
6. Bodh V, Sharma B, Kumar R, Sharma R. Current trends in etiological profile of acute upper gastrointestinal bleeding in Northern India: a retrospective analysis of 5-year endoscopic data. Journal of Digestive Endoscopy. 2021 Mar;12(01):031-5.
7. Stewart BW, Khanduri P, McCord C, Ohene-Yeboah M, Uranues S, Vega Rivera F, Mock C. Global disease burden of conditions requiring emergency surgery. Journal of British Surgery. 2014 Jan;101(1):e9-22.
8. Loperfido S, Baldo V, Piovesana E, Bellina L, Rossi K, Groppo M, Caroli A, Dal Bò N, Monica F, Fabris L, Salvat HH. Changing trends in acute upper-GI bleeding: a population-based study. Gastrointestinal endoscopy. 2009 Aug 1;70(2):212-24.
9. Hreinsson JP, Kalaitzakis E, Gudmundsson S, Björnsson ES. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scandinavian journal of gastroenterology. 2013 Apr 1;48(4):439-47.
10. Mumtaz K, Kamani L, Hamid S, Abid S, Shah HA, Jafri W. Impact of a bleeding care pathway in the management of acute upper gastrointestinal bleeding. Indian Journal of Gastroenterology. 2011 Mar;30:72-7.
11. Saravana Krushna Raja KS. Clinical study, Evaluation and Management of Upper Gastrointestinal Bleeding (Doctoral dissertation, Stanley Medical College, Chennai).
12. Thomson M, Tringali A, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, Spaander M, Hassan C, Tzvinikos C, Ijsselstijn H, Viala J. Paediatric gastrointestinal endoscopy: European society for paediatric gastroenterology hepatology and nutrition and European society of gastrointestinal endoscopy guidelines. Journal of pediatric gastroenterology and nutrition. 2017 Jan 1;64(1):133-53.
13. Bhattarai S. Clinical profile and endoscopic findings in patients with upper gastrointestinal bleed attending a tertiary care hospital: a descriptive cross-sectional study. JNMA: Journal of the Nepal Medical Association. 2020 Jun;58(226):409.
14. Longstreth GF. Epidemiology of Hospitalization for Acute Upper Gastrointestinal Hemorrhage: A Population--Based Study. American Journal of Gastroenterology (Springer Nature). 1995 Feb 1;90(2).
15. Charatcharoenwitthaya P, Pausawasdi N, Laosanguaneak N, Bubthamala J, Tanwandee T, Leelakusolvong S. Characteristics and outcomes of acute upper gastrointestinal bleeding after therapeutic endoscopy in the elderly. World Journal of Gastroenterology: WJG. 2011 Aug 8;17(32):3724.
16. Abd Elrazek MA, Mahfouz HM, Metwally AM, El-Shamy AM. Mortality prediction of nonalcoholic patients presenting with upper gastrointestinal bleeding using data mining. European Journal of Gastroenterology & Hepatology. 2014 Feb 1;26(2):187-91.
17. Terrier B, Saadoun D, Sène D, Scerra S, Musset L, Cacoub P. Presentation and outcome of gastrointestinal involvement in hepatitis C virus-related systemic vasculitis: a case–control study from a single-centre cohort of 163 patients. Gut. 2010 Jan 1:gut-2010.
18. Rockey DC, Elliott A, Lyles T. Prediction of esophageal varices and variceal hemorrhage in patients with acute upper gastrointestinal bleeding. Journal of Investigative Medicine. 2016 Feb;64(3):745-51.
19. Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. Bmj. 2019 Mar 25;364.
20. Yakoob J, Abbas Z, Jafri W, Usman MW, Jafri F, Awan S. Comparison of the virulence markers of Helicobacter pylori and their associated diseases in patients from Pakistan and Afghanistan. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association. 2013 Sep;19(5):211.
21. Rahman Afridi MA, Salma Rashid U, Kamran Hassan M, Fahim Afridi M. ACUTE UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH CIRRHOSIS: ENDOSCOPIC FINDINGS. JPMI: Journal of Postgraduate Medical Institute. 2023 Jan 1;37(1).
22. CM S, Sharma GD, Rana BS. Profile of acute upper gastro intestinal bleed: a referral hospital-based study in sub Himalayan region. International Journal of Advances in Medicine. 2018 Jul;5(4):849.

Most read articles by the same author(s)

1 2 > >>