Emrah ALPER, Behlül BAYDAR, Cem ÇEKİÇ, Fatih ASLAN, Serdar AKÇA, Belkıs ÜNSAL

Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri

Amaç: Non variseal üst gastrointestinal sistem kanaması dünyada acil hastaneye yatış nedenleri arasında yaygındır ve hala yüksek mortalite oranlarına neden olur. Bu çalışmada, üst gastrointestinal sistem kanamasına neden olan lezyonlar Forrest sınıflamasına gore değerlendirildi ve bu lezyonlarla tekrar kanama arası ilişki açıklandı. Yöntem ve Gereç: Bu çalışma, tersiyer eğitim ve araştırma hastanesinde retrospektif olarak yapılmıştır. Kasım 2005 ile Mayıs 2009 arasında, son 24 saatte üst gastrointestinal sistem kanaması gelişen ve hastaneye başvuran hastalar çalışmaya alındı. Binaltıyüzkırkyedi hastanın verileri analiz edildi ve 1342 hastanın verileri değerlendirildi. Bulgular: Lezyonların dağılımı: 96'sı (%7.15) özofagusta, 552'si (%41.13) midede, 523'ü (%38.97) duodenumda ve 171'i (%12.74) birden çok bölgede yerleşmiştir. Ayrıca 34 (%2.53) lezyon Forrest Ia, 192'si (%14.31) Forrest Ib, 85'i (%6.33) Forrest IIa, 121'i (%9.02) Forrest IIb, 210'u (%15.65) Forrest IIc ve 700'ü (%52.16) Forrest III olarak sınışanmıştır. Sonuç: Sonuç olarak, non-variseal üst gastrointestinal sistem kanamalarının Forrest sınıflamasına göre değerlendirilmesinde, Forrest Ia, Ib ve IIa gruplarında tekrar kanama oranı, diğerleriyle kıyaslandığında daha yüksekti. Tekrar kanama riskini belirlemek için endoskopik değerlendirmenin ilk 12 saat içinde Forrest sınıflamasına göre yapılmasını önerebiliriz.

Anahtar Kelimeler:

Tekrar kanama, üst gastrointestinal kanama, Forrest sınıflaması

Endoscopic findings of non-variceal upper gastrointestinal system bleeding and the relationship to rebleeding

Background and Aims: Non-variceal upper gastrointestinal system bleeding is among the common reasons for urgent hospitalization worldwide and still causes high rates of mortality. In the present study, the lesions causing upper gastrointestinal bleeding were evaluated according to Forrest classification and the relationship between these lesions and rebleeding was elucidated. Materials and methods: The present study is a retrospective study conducted in a tertiary training and research hospital. Patients who were admitted between November 2005 and May 2009 with upper gastrointestinal bleeding developed within the previous 24 hours were included in the study. The data of 1647 patients were analyzed, and of those, the data of 1342 were evaluated and the results are reported herein. Results: Distribution of the lesions was as follows: 96 (7.15%) esophagus, 552 (41.13%) stomach, 523 (38.97%) duodenum, and 171 (12.74%) in multiple areas. It was also demonstrated that 34 (2.53%) of the lesions were classified as Forrest Ia, 192 (14.31%) as Forrest Ib, 85 (6.33%) as Forrest IIa, 121 (9.02%) as Forrest IIb, 210 (15.65%) as Forrest IIc, and 700 (52.16%) as Forrest III. Conclusion: In conclusion, evaluation of non-variceal upper gastrointestinal bleeding according to the Forrest classification demonstrated that the rate of rebleeding in the Forrest Ia, Ib and IIa groups was higher when compared to the others. It is suggested that endoscopic evaluation within the first 12 hours should be performed according to the Forrest classification in order to determine the risk of rebleeding.

Keywords:

Rebleeding, upper gastrointestinal bleeding, Forrest classification,

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