Sugihartono, Titong; Hernomo, O. K.; Nusi, Iswan A.; Adi, Pangestu; Boedi, S. Poernomo; Purbayu, Herry
April 2010
Folia Medica Indonesiana;abr2010, Vol. 46 Issue 2, p146
Academic Journal
Gastrointestinal (GI) bleeding is an extremely common clinical problem, resulting in significant morbidity, mortality, and cost. The overall incidence of upper GI bleeding is approximately 100 cases per 100,000 population and accounting for 1-2% of all hospital admissions. In the western, acid peptic disease (e.g., gastric and duodenal ulcers as well as gastritis) is the most common cause of upper GI bleeding, accounting for 50-75% of all cases, even among patients with chronic alcohol use, portal hypertension, and varices. At dr. Soetomo hospital- Surabaya, variceal bleeding is the most common cause of upper GI bleeding along decade 1990s. The initial assessment is important to define factors that have prognostic importance. The main factors predicting death include increasing age, co morbidity, and endoscopic findings. Mortality is extremely low in patients under 40 years old but thereafter increases steeply with advancing age. The objective of this study was to determine the source of upper gastrointestinal bleeding by performing endoscopic examination among patients with haematemesis and or melena at Dr. Soetomo Hospital Surabaya. This was a descriptive study which retrospectively based on the data all patients with haematemesis and or melena who performed esophago-gastro-duodenoscopic examination at dr.Soetomo hospital between 01 January 2006 to 30 December 2008. In year 2006, esophageal varices bleeding was the commonest cause of upper gastrointestinal bleeding (40.06%), followed by erosive gastritis (37.89%), peptic ulcer (5.28%), and malignancy (5.28%). In year 2007 the common cause of upper GI bleeding was similar with esophageal varices bleeding still the commonest cause (32.24%), followed by erosive gastritis (30.2%), peptic ulcer (13.88%), and malignancy (12.24%). The features of upper GI bleeding along 2008 reveald that erosive gastritis become the most common cause (42.66%), and followed by esophageal varices bleeding, peptic ulcer, and malignancy respectively 27.99%, 11.26%, and 3.41%. Percentage of patients with age over 50 years old were 54.94% in year 2006, 59.59% in year 2007 and 64.16% in year 2008. As conclusion, at Dr. Soetomo Hospital Surabaya, there was change of the most common cause upper gastrointestinal bleeding prior due to variceal esophagus in 2006 and 2007 became erosive gastritis predominantly in 2008.


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