Acute Upper Gastrointestinal Bleeding in Southern Saudi Arabia

OBJECTIVES: to study the incidence of hospitalisation, causes, and outcomes of acute upper gastrointestinal bleeding (AUGIB) in southern Saudi Arabia. DESIGN AND METHODS: prospective study of patients admitted with AUGIB to a large district hospital in Abha City, southern Saudi Arabia, between 1991 and 1993. All patients had upper endoscopy within 24 hours of admission. RESULTS: AUGIB was the indication for upper endoscopy in 240 (8.9%) of all upper gastrointestinal endoscopies (2,702). The patients' mean age was 44.3 years (SD 18.1; range 20–85 years). The annual hospital admission rate for AUGIB was calculated as 31 per 100,000 population over the age of 20. The commonest causes were oesophageal varices (30%), gastritis and erosions (25%) and duodenal ulcers (22%); gastric ulcers and malignancy were relatively uncommon. Liver cirrhosis due to hepatitis B and C viruses was the main cause of bleeding oesophageal varices. Patients with variceal bleeding were younger and had a higher mortality rate than non-variceal bleeders. CONCLUSIONS: bleeding oesophageal varices are the commonest cause of AUGIB in Saudi Arabia owing to the endemicity of viral hepatitis B and C. The mortality from both variceal and non-variceal bleeding was lower than in western countries probably because the patients are younger and because of the relative rarity of malignancy and of the consumption of non-steroidal anti-inflammatory drugs.