Original Paper Management of Non-Variceal Upper Gastrointestinal Bleeding - from Theory to Practice

The upper gastrointestinal bleeding (UGIB) represents one of the most frequent medical and surgical emergencies. Upper GI endoscopy allows the treatment of the majority of lesions being associated with low transfusion requirement and decreasing of number of hospitalization days. Aim and method The aim of our study was to assess the clinical application of the elaborated guidelines for the management of upper GI bleeding in the Clinical County Emergency Hospital of Craiova. We assessed 100 consecutive patients with non-variceal upper gastrointestinal bleeding admitted through the Emergency Department. Results Upper GI endoscopy was performed in the first 24 hours in 50 % and as an elective procedure in 36 % of the patients. Therapeutic endoscopy was applied in 13.95% of the patients submitted for upper GI endoscopy Successful endoscopic haemostasis was performed in 85.7 % of cases, with re-bleeding and inefficient haemostasis in 14.3 %. Immediate surgery was necessary in 7 % of cases, 5 % of the patients were operated without previous upper GI endoscopy and 2 % after the failure of endoscopic haemostasis. Conclusion Although the algorithms of diagnosis and treatment were clearly designed, the assessment of the patients with non-variceal bleeding is incomplete and incorrect, in the absence of emergency endoscopy departments and dedicated intensive care compartments.