Causes of Upper Gastrointestinal Bleeding in Sudanese Patients

Abstract

Upper gastrointestinal bleeding in Sudan is a common problem with significant mortality and morbidity and consumption of already scarce medical resources in our country. This study was conducted in Khartoum province, in the main three Tertiary hospitals; Khartoum teaching hospital; Ibn Sina specialized hospital and Soba university hospital. One hundred cases were studied in each hospital in the period from October 2002 to August 2003. The aim of the study was to know the potential causes of upper gastrointestinal tract bleeding in Sudanese patients. Important investigations were done to the patients. These include: oesophagogastroduod-endoscopy, abdominal ultrasonography, liver function tests prothrombin time, complete blood count with peripheral blood picture. The study showed the dominance of the variceal causes, mainly due to bleeding oesophageal varices, resulting from schistosomal periportal fibrosis which contributed to 76% of the causes. Most of the patients were from Gezira area which is indemic for schistosomiasis. Peptic ulcer disease accounted for 9.7% of the cases. Other causes found were gastric erosion (2%), carcinoma of the stomach (2.7%), and Mallory-Weiss (0.7%). Other rare causes found in this study include: Dieulafoy lesions (0.7%), watermelon stomach (1%), duodenal tumors, and A-V malformations (0.3%). There is a rise in the percentage of patients with bleeding oesphageal varices compared to a previous study done almost twenty years ago. Also, this study shows a decrease in the percentage of patients with bleeding peptic ulcers.