Value of Nasogastric Tube in Emergency Upper Gastrointestinal Bleeding in Zagazig University Hospitals

Sahar Goda Zaghlol; Mohamed H. Ebrahim; Waseem M. Seleem; Afifi Fahmy Afifi

Volume : IV, Issue : VIII, August - 2014

Value of Nasogastric Tube in Emergency Upper Gastrointestinal Bleeding in Zagazig University Hospitals

Sahar Goda Zaghlol, Mohamed H. Ebrahim, Waseem M. Seleem, Afifi Fahmy Afifi

Abstract :

Background : Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency with an annual rate of 150–200 hospitalization per 100.000 populations and a 5–10% mortality rate. A nasogastric (NG) lavage may be performed as the first diagnostic procedure since a bloody aspirate confirms the source of bleeding as being proximal to the pylorus. Aim of the work : The aim of this work is to study the value of gastric lavage by nasogastric tube (NGT) before upper gastrointestinal endoscopy for patients with emergency UGIB. Subjects and Methods : Out of 650 patients presented with haematemesis and/or melena, 148 patients (38 females and 110 males) had completed the study, they were divided into NGT group which included 74 patients and non–NGT group which included 74 patients. According to patients clinical history and laboratory findings; patients who were suspected to have esophageal varices (OV) received either the standard treatment of care or the local practice treatment of OV and those who were not suspected to have OV received either the standard treatment of care or the local practice treatment of peptic ulcer disease. According to the endoscopic finding our patients were rearranged in retrograde manner into two groups: OV group which included 88 patients (44 patients with NGT and 44 patients without NGT) in each group 32 patients received the standard treatment of care and the other 12 patients received local practice treatment. Peptic ulcer group which included 60 patients (30 patients with NGT and 30 patients without NGT) in each group 15 patients received the standard treatment of care and the other 15 patients received local practice treatment. Results : There was a statistical significant difference between OV group of patients with and without NGT as regards both the time lapsed from admission to endoscopic procedure (P<0.03) and the outcome of medical care (P<0.001). Considering some clinical parameters in peptic ulcer group there was no statistical significant differences between patients. Conclusion and Recommendation : Patients with NGT were associated with clear endoscopic field with less rebleeding and encephalopathy but unfortunately they had longer time before endoscopy and longer stay in ER. After all we recommend use of NGT shortly before endoscopy for diagnosis of UGIB and cleå the field of vision.