ENDOSCOPIC EVALUATION OF PATIENTS WITH UPPER GI BLEEDING AND ENDOSCOPIC MANAGEMENT OF PATIENTS WITH ESOPHAGEAL AND GASTRIC VARICEAL BLEEDING: A HOSPITAL BASED STUDY FROM NORTH EASTERN INDIA

Introduction: Upper GI bleeding is a common medical emergency worldwide and it is an alarm symptom for the patients. Acute variceal bleeding is the most significant cause for morbidity and mortality as the bleeding is massive and usually life threatening. Upper GI Endoscopy is an important diagnostic tool and it is the preferred modality of choice for the evaluation of patients with Upper GI bleeding because of the additional therapeutic intervention that can be carried out either in the same sitting or later as the case may be. Materials and Methods: This is a hospital based retrospective observational study carried out in a tertiary hospital over a period of five years from January 2021 to December 2025. All patients with Upper GI bleeding referred for upper GI endoscopy were included in the study. Out of total 12,543 Upper GI endoscopies carried out in the above mentioned period, 673 endoscopies were advised for evaluation of Upper GI bleeding. Results: Out of 673 endoscopies referred for evaluation of UGI Bleeding, abnormal findings were detected in 578 (85.88%) patients. The number of patient with Esophageal varices were 67 (9.95%) ant that of Gastric varices was 17 (2.52%). All patients with esophageal and gastric variceal bleeding were initially managed conservatively before they were taken up for Endoscopy within 12 hours of hospital admission. Out of 67 patients with esophageal variceal bleeding, 51(76.11%) patients underwent Endoscopic variceal ligation (EVL) and 16 (23.88%) patients were given Injection sclerotherapy with absolute alcohol. Cyanoacrylate glue injection was given to all patients with gastric variceal bleeding. A total number of 5 patients with esophageal variceal bleeding and 3 patients with gastric variceal bleeding had rebleed within 72 hours and succumbed to their illness. While 7 patients with esophageal variceal bleeding had mild bleeding in the one month follow up period due to post EVL ulcers. Conclusion: UGI Endoscopy is an important diagnostic tool for evaluation of patient’s with Upper GI bleeding. Acute variceal bleeding is the most important cause of morbidity and mortality and endoscopic intervention is the best options for managing such patients with a good outcome.