Digestive endoscopy-first intention exploration of the patients with gastrointestinal bleeding of portal genesis

Abstract

Introduction. Endoscopic diagnosis is essential in upper gastrointestinal bleeding and has an impact on the therapeutic behavior. Aim of the study. Evaluation of the digestive endoscopy (DE) input in variceal gastrointestinal bleeding (VGB) of portal genesis. Materials and methods. We studied the cases of 30 cirrhotic patients, who had variceal gastrointestinal bleeding, in between 2017-2020. We looked into: gender distribution, diagnostic and hemostatic applicability of digestive endoscopy, morbidity and mortality. The hemostasis methods used were: medical therapy (n = 30), associated with endoscopic ligation (from 1 to 3 sessions) in full bleeding (n = 21) and histoacryl injection sclerotherapy (n = 2 cases). Results. Distribution of cases: HCV/HBV liver cirrhosis (n=11/19), Child B / C score (n=8/22), grade II/III esophageal varices (n=3/25), active variceal gastrointestinal bleeding (n=21), hemorrhagic shock (n=11), previous episode of variceal gastrointestinal bleeding (n=5), major splenomegaly/severe hypersplenism (n = 19), ascites (n = 9). The success rate of endoscopic hemostasis was 96.3%. Intra-hospital mortality was 16.7% (n = 5), associated with Child C score, recurrent variceal gastrointestinal bleeding, hemorrhagic shock. Conclusions. Digestive endoscopy has an acceptable diagnostic performance of esophageal varices and good hemostatic/prophylactic applicability.