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Abstract
The study was conducted on 494 patients with acute variceal bleeding in Zagazig University hospital from 1/1/2003 till 1/9/2003.
The aim of this work was to study the impact of timing of endoscopy in acute variceal bleeding on hospital mortality and morbidity.
All patients were subjected to the following:
1. Clinical evaluation. 2. Immediate resuscitation.
3. Laboratory investigations. 4. Upper GI endoscopy.
5. Abdominal ultrasonography.
Endoscopy was done early within 12 hours in 310 cases (62.8 %) and was done late after 12 hours in 184 cases (37.2 %) , 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 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:
• 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.
• Early endoscopy (performed within 12 hours of admission) : after hemodynamic stability has been obtained, in intermediate and low risk patients.