masterThesis
Caracterización de los pacientes con hemorragia de vías digestivas altas no varicosa atendidos en el Hospital Universitario de la Samaritana, Cundinamarca
Fecha
2013Autor
Rivera Henríquez, Daysi Beatriz
Institución
Resumen
Upper GI bleeding is one of the most common emergencies in the emergency department. The most common etiology is peptic ulcer disease. Restoring intravascular volume and stabilization of blood pressure are the priorities in its management. Endoscopy should be performed after initial resuscitation and hemodynamic stabilization is achieved, and treat the underlying lesion with various techniques for hemostasis. We present a study conducted in a third level referral hospital, in Cundinamarca, ColombiaMaterials and methods: We retrospectively reviewed electronic medical records of all adults patients who presented to the emergency department of Hospital Universitario de la Samaritana (HUS) with upper gastrointestinal bleeding symptoms such as hematemesis, melena, hematochezia and/or anemia; all of whom underwent esophagogastroduodenoscopy between April 2010 -2011. Results: 385 patients were evaluated during the study period, 100 of them were excluded for variceal bleeding, incomplete medical history or lower intestinal bleeding; a total of 285 patients were included. 69. 1% were older than 60 years, 73. 3% had a history of arterial hypertension, 55. 1% chronically used NSAID´s or ASA. 19. 6% had previously experienced at least one episode of intestinal bleeding and 17. 9% of all patients presented hemodynamic instability. Sixty three patients required endoscopic hemostasis and 32 of them showed bleeding recurrence. The mortality for this group was 13. 1% and 55. 3% were men. Discussion. The majority of patients treated at our institution for gastrointestinal bleeding are older than 60 years. Peptic ulcer disease remains the most frequent cause and is strongly associated to NSAID´s or ASA use