Epidemiology of upper GI bleeding in a Nigeria Teaching Hospital

Upper GI endoscopy is a very useful tool in the diagnosis and treatment of upper GI bleeding. It is highly accurate in establishing an accurate diagnosis. The sensitivity and specificity of endoscopy have been reported as 92% to 98% and 33% to 100%, respectively. In Nigeria and many developing countries, upper GI endoscopy services are not readily available nor affordable for most patients. Our centre introduced the Endoscopy Services about two years ago and we present our findings on those patients who were referred to us as a result of upper GI Bleeding. This is a retrospective study of all patients referred to our endoscopy unit as a result of upper GI Bleeding. The study period was two years (2002-2003). The studies were carried out at Aminu Kano Teaching Hospital, Kano and Maranatha Specialist Hospital, Aba, Nigeria. Data were collected from medical records of all patients on a standard form which included age, sex, clinical presentation, endoscopic findings and etiology. A total of 73l patients had upper GI endoscopy during the study period of two years (2002-2003). Out of this number, 32(4.37%) were referred as a result of recent upper GI Bleeding. Most of the patients were Males (24) accounting for 75% of all the Patients. The age ranged from 18-75 years. Majority of the patients (81%) were below the age of 60years. The commonest aetiology was Peptic Ulcer(37.5%) of which Duodenal Ulcer was commoner(75%). Bleeding from esophageal varices and Gastritis accounted for 18.75% each. Gastric Malignancies were the cause in 15.6% of the series. In 9.37%, no obvious pathology was seen on endoscopy. Considering the fact that the major causes of upper GI bleeding in our study are preventable or at least treatable (helicobacter, Hepatitis B, aflatoxins, NSAIDs abuse), efforts should be geared towards the eradication of these preventable problems. Health education, improved hygiene and increased funding of our Health Institutions will go a long way in significantly reducing the incidence, morbidity and mortality of upper GI bleeding. © EuroJournals Publishing, Inc. 2006.