HAEMOSTASIS AFTER ENDOSCOPIC INTERVENTION IN UPPER GASTROINTESTINAL BLEEDING: A RETROSPECTIVE AUDIT

BACKGROUND: Upper Gastrointestinal Bleeding is a common medical emergency .This retrospective audit looks at the endoscopic practice at our hospital over a period of one year based on guidance.METHODS: The GI-Auditor's-Tool was used to select patients undergoing Upper Gastrointestinal Endoscopy presenting with Haematemesis and/or malena and who had undergone endoscopic intervention over a period of one year. Endoscopy reports taken from Unisoft-GI-Reporting tool were then analysed.RESULTS: A total of 969 of patients were selected. 168 (15.5%) required endoscopic intervention. Varices (31%), Duodenal Ulcers (30%), Gastric Ulcers (14%) and Mallory Weiss Tears (5%) were the main causes of bleeding. 58% received Dual Therapy and 42% received mono-therapy. 6(5.4%) received mechanical therapy(clips) only. Haemostasis was achieved in all but 3 cases. 26(15.5%) patients underwent repeat endoscopy. 11(6.5%) required further endoscopic intervention. In 71(42%) cases the lesion was oozing and 6(3.5%) cases was spurting. In 13% of cases the plan could have been clearer. 23% of the non-variceal bleeders had 5mls or less of adrenaline used, 46% had 6-10mls used and 26% had more than 11mls of adrenaline. 61(55%) of non-variceal bleeds had a visible vessel, 43(39%) had an adherent clot and 9 (8%) had pigmented bases.CONCLUSIONS: Peptic ulcers and Oesophageal Varices remain the leading causes of Gastrointestinal Bleeding. Dual Modalities of endoscopic treatment was underutilised and should be advocated in line with advice. A re-audit is required to assess practice in the future.