الفهرس 
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Abstract
The study was conducted on 106 patients with acute variceal bleeding
in Beni-Suef University hospital from 1/1/2009 till 1/7/2009.
The aim of this work was to study the impact of timing of upper GI
endoscopy in acute variceal bleeding on hospital mortality and morbidity.
All patients were subjected to the following:
· Clinical evaluation.
· Immediate resuscitation.
· Laboratory investigations (liver, kidney function, CBC)
· Abdominal ultrasonography.
· Upper GI endoscopy.
Patients were classified into early endoscopy within 12 hours and
late endoscopy after 12 hours.
Endoscopy was done early within 12 hours in 44 cases (50%) and was
done late after 12 hours in 44 cases (50%), based on admission to endoscopy
time.
The results of this study showed that: early endoscopy (<12 hours) in
acute variceal bleeding, was associated with less incidence of hospital mortality
and morbidity than delayed endoscopy (>12 hours).
We have developed the hospital mortality predictive scoring
system for acute variceal bleeding from the results of this study and the patients
179
were divided into three groups according to their risk of hospital mortality; low,
intermediate and high-risk groups.
We have concluded from this study that: timing of endoscopy in
patients with acute variceal bleeding can be divided into two categories
according to the patient risk:
o Urgent endoscopy: as soon as the patient has been
resuscitated and is hemodynamically stable (optimally
within the first 4 hours of admission) in patients with
high mortality risk, decreases mortality and morbidity.
o Early endoscopy (performed within 12 hours of
admission): after hemodynamic stability has been
obtained, in intermediate and low risk patients.
The incidence of SBP and HRS decrease in patients who do
early endoscopy (within 12h.) than patients who do endoscopy later
on.
Increased incidence of mortality in cases of SBP and HRS was
noticed.