• J Laparoendosc Adv Surg Tech A · Aug 2006

    Management of acute upper gastrointestinal bleeding in a district hospital.

    • Abdul M Kasem, Tamer Kamal, Nanjanagud N Chandra, Iyad Dayoub, Hudson Munyira, and Shamsi El-Hasani.
    • Princess Royal University Hospital, Farnborough Common, United Kingdom. abkasem@doctors.net.uk
    • J Laparoendosc Adv Surg Tech A. 2006 Aug 1;16(4):355-61.

    BackgroundThis study was conducted to assess the management of acute upper gastrointestinal bleeding in a district hospital and to compare these results with national guidelines and the published literature.Materials And MethodsThis prospective and retrospective study included 112 patients, mean age 66 years, who presented with acute upper gastrointestinal bleeding between July 2004 and February 2005. All patients were assigned a Rockall risk assessment score.ResultsThe surgical on-call teams managed all the patients according to an agreed protocol. Forty-nine patients had a Rockall score > or =4. Endoscopy was performed in all patients, with 60% accomplished within the first 24 hours. The most common cause found was peptic ulcer (30%). Therapeutic endoscopy was undertaken in 10 patients (9%) with a success rate of 70%. Open surgery was performed in 3 patients. One patient died after having surgery and the Rockall score was >5. Of the patients admitted with acute upper gastrointestinal bleeding, 90.2% were discharged without complication. Eleven patients died (9.8%) and all of them from the high risk group with Rockall scores > or =5. Their mean hospital stay was 17.8 days (range, 2-43 days).ConclusionHigh-standard results in acute upper gastrointestinal bleeding can be achieved in a district hospital. The management, including the use of the operating theater facilities with operative and anesthetic support, was safe and efficient. A 24-hour-a-day endoscopy service is important to achieve early diagnosis and to plan management. A protocol and early endoscopy improve clinical outcome and reduce mortality, which occurred mostly among elderly patients with high risk scores. It is advisable to introduce the Rockall scoring system in practice.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…