ACUTE UPPER GASTROINTESTINAL-BLEEDING IN SOUTHERN SAUDI-ARABIA

Objectives: to study the incidence of hospitalisation, causes, and out comes of acute upper gastrointestinal bleeding (AUGIB) in southern Sau di Arabia. Design and methods: prospective study of patients admitted with AUGIB to a large district hospital in Abha City, southern Saudi A rabia, between 1991 and 1993. All patients had upper endoscopy within 24 hours of admission. Results: AUGIB was the indication for upper end oscopy 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 oesop hageal 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 bleed ing oesophageal varices. Patients with variceal bleeding were younger and had a higher mortality rate than nonvariceal bleeders. Conclusions : bleeding oesophageal varices are the commonest cause of AUGIB in Sau di Arabia owing to the endemicity of viral hepatitis B and C. The mort ality from both variceal and non-variceal bleeding was lower than in w estern countries probably because the patients are younger and because of the relative rarity of malignancy and of the consumption of non-st eroidal anti-inflammatory drugs.