AN ANALYSIS OF UPPER GI ENDOSCOPY DONE FOR PATIENTS IN SURGICAL INTENSIVE-CARE - HIGH-INCIDENCE OF, AND MORBIDITY FROM REFLUX ESOPHAGITIS

Objective: To investigate the role of upper gastrointestinal (GI) endo scopy in a surgical intensive care unit [ICU]. Design: Retrospective a nalysis. Setting: University hospital, The Netherlands. Subjects: 87 M ale and 42 female patients, mean age 62.0 years (range 14-86). Interve ntions: 198 Upper GI endoscopies. Main outcome measures: Incidence of, indication for, and abnormalities noted at upper GI endoscopy. Result s: 52 (40%) and 18 (14%) patients underwent 8% and 27 upper GI endosco pies, respectively, for evaluation of upper GI haemorrhage and surgica l anastomoses. 59 Patients (46%) underwent 89 endoscopies for placemen t of nasoduodenal feeding tubes (n = 86, 97%), biliary stents (n = 2, 2%) and gastrostomy cathether (n = 1, 1%). The causes of haemorrhage w ere: oesophagitis (n = 13, 25%), duodenal ulcer (n = 13, 25%), gastric ulcer (n = 7, 13%) and others (n = 14, 28%). In 6 cases (11%), no ble eding site was detected. As a coincidental finding, a third of all pat ients had oesophagitis. The incidence of haemorrhage in patients treat ed and not treated by mechanical ventilation was 43/1350 (3.2%) and 9/ 1470 (0.6%), respectively (p < 0.0001). Conclusions: Upper GI endoscop y is a common diagnostic and therapeutic procedure in a surgical ICU. Reflux oesphagitis is often found and is clinically important. Mechani cal ventilation is a risk factor for upper GI haemorrhage.