Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.
Lau, J.Y., Barkun, A., Fan, D., Kuipers, E.J., Yang, Y. and Chan, F.K. (2013) Challenges in the Management of Acute Peptic Ulcer Bleeding. The Lancet , 381, 2033-2043. https://doi.org/10.1016/s0140-6736(13)60596-6
Acosta, R.D. and Wong, R.K.H. (2011) Differential Diagnosis of Upper Gastrointestinal Bleeding Proximal to the Ligament of Trietz. Gastrointestinal Endoscopy Clinics of North Americ a , 21, 555-566. https://doi.org/10.1016/j.giec.2011.07.014
Ouazana, S. and Leenhardt, R. (2021) Prise en charge de l’hémorragie digestive haute: Vous avez dit fréquent et grave? La Presse Médicale Formation , 2, 466-473. https://doi.org/10.1016/j.lpmfor.2021.10.019
Forrest, J.H., Finlayson, N.D.C. and Shearman, D.J.C. (1974) Endoscopy in Gastrointestinal Bleeding. The Lancet , 304, 394-397. https://doi.org/10.1016/s0140-6736(74)91770-x
Blatchford, O., Murray, W.R. and Blatchford, M. (2000) A Risk Score to Predict Need for Treatment for Uppergastrointestinal Haemorrhage. The Lancet , 356, 1318-1321. https://doi.org/10.1016/s0140-6736(00)02816-6
Kodjoh, N., Hountondji, A. and Addra, B. (2024) Hemorragies Digestives Hautes et Pathologie Oeso-Gastro-Duodenale dans un Service de Medecine Interne en Milieu Tropical. https://www.santetropicale.com/Resume/13904.pdf
Chaabane, N., Youssef, H., Ghedira, A., Loghmeri, H., Melki, W., Hellara, O., et al . (2010) Upper Gastrointestinal Bleeding Epidemiology in Tunisia. Acta Endoscopica — Acta Endoscopica , 40, 176-182.
Dicko, M., Samake, D.K.W., Coulibaly, S.H.W., Soumaré, G., Tounkara, M., Katilé, D., et al . (2018) Acute Upper Digestive Bleedings in Hospital in Bamako. Open Journal of Gastroenterology , 8, 387-393. https://doi.org/10.4236/ojgas.2018.811040
Doumbia, K., Sow, H., Dicko, M.Y., Sanogo, S.D., Tounkara, M.S., Péliaba, K., et al. (2021) Digestive Bleeding by Rupture of Esophageal Varicose Veins and Prognosis Value of Blood Transfusion in the Hepatogastroenterology Department of the Gabriel Toure Hospital. Open Journal of Gastroenterology , 11, 75-80. https://doi.org/10.4236/ojgas.2021.115008
Diarra, M., Soucko-Diarra, A., Dolo, M., Traore, H. and Diallo, A. (2007) Hémorragies digestives hautes aiguës: Expérience d’un milieu rural. Acta Endoscopica , 37, 321-326. https://doi.org/10.1007/bf02961922
Koumaré, M.G. (2019) Hémorragie digestive par rupture des varices oesophagiennes et valeur pronostique de la transfusion sanguine dans le service d’Hépato-gastroen-térologie du CHU Gabriel Touré. https://library.adhl.africa/handle/123456789/8983
Nahon, S., Hagège, H., Latrive, J., Rosa, I., Nalet, B., Bour, B., et al . (2012) Epidemiological and Prognostic Factors Involved in Upper Gastrointestinal Bleeding: Results of a French Prospective Multicenter Study. Endoscopy , 44, 998-1008. https://doi.org/10.1055/s-0032-1310006
Chassaignon, C., Letoumelin, P. and Pateron, D. (2003) Upper Gastrointestinal Haemorrhage in Emergency Departments in France: Causes and Management. European Journal of Emergency Medicine , 10, 290-295. https://doi.org/10.1097/00063110-200312000-00010
Hagège, H., Latrive, J., Nalet, B., Rosa, I., Bour, B., Faroux, R., et al . (2006) Hémorragies digestives hautes communautaires: Résultats préliminaires de l’étude de l’ANGH sur plus de 1000 patients. Endoscopy , 38, A925. https://doi.org/10.1055/s-2006-934120
Bignoumba, P.E.I., Moussavou, I.F.M. and Kombila, J.B.M. (2019) Hémorragie Digestive Haute au Centre Hospitalier Universitaire de Libreville : Aspects Cliniques et Prise en Charge Réelle : À Propos de 210 Patients. Health Sciences and Disease , 20, 20-22. https://www.hsd-fmsb.org/index.php/hsd/article/view/1417
El Mekkaoui, A., Mellouki, I., Berraho, M.A., Saâda, K., Elyousfi, M., Aqodad, N., et al . (2011) Épidémiologie, étiologie et évolution des hémorragies digestives hautes au centre hospitalier universitaire de Fès, Maroc. Acta Endoscopica , 41, 337-343. https://doi.org/10.1007/s10190-011-0206-4
Benajah, D.-A., Aqodad, N., El Fakir, S., El Abkari, M., Nejjari, C. and Ibrahimi, A. (2009) Les hémorragies digestives ulcéreuses au CHU Hassan-II de Fès: Approche épidémiologique. Journal Africain d ’ Hépato - Gastroentérologie , 3, 16-21. https://doi.org/10.1007/s12157-009-0067-z
Ben Chaabane, N., Ben Youssef, H., Ghedira, A., Loghmeri, H., Melki, W., Hellara, O., et al . (2010) Épidémiologie des hémorragies digestives hautes en Tunisie. Acta Endoscopica , 40, 176-182. https://doi.org/10.1007/s10190-010-0049-4
Nahon, S., Hagège, H., Latrive, J., Rosa, I., Nalet, B., Bour, B., et al . (2012) Epidemiological and Prognostic Factors Involved in Upper Gastrointestinal Bleeding: Results of a French Prospective Multicenter Study. Endoscopy , 44, 998-1008. https://doi.org/10.1055/s-0032-1310006
Gaudong Mbethe, G.L., Mounguengui, D., Ondounda, M., Magne, C., Bignoumbra, R., Ntsoumou, S., et al . (2014) Epidemiology of Upper Gastrointestinal Bleeding in Gabon. Médecine et Santé Tropicales , 24, 441-443. https://doi.org/10.1684/mst.2014.0376
Traoré, O., Diarra, A.S., Kassogué, O.S., Abu, T., Maïga, A.S. and Kanté, M. (2021) The Clinical and Endoscopic Aspects of Peptic Ulcers Secondary to the Use of Nonsteroidal Anti-Inflammatory Drugs of Various Origins. Pan African Medical Journal , 38, 170. https://doi.org/10.11604/pamj.2021.38.170.17325
Bagny, A., Bouglouga, O., Djibril, M.A., Mba, K.B. and Redah, D. (2012) Profil étiologique des hémorragies digestives hautes de l’adulte au CHU-campus de Lomé (Togo). Journal Africain d ’ Hépato - Gastroentérologie , 6, 38-42. https://doi.org/10.1007/s12157-012-0356-1
Kodjoh, N., Hountondji, A. and Addra, B. (1992) Hémorragies digestives hautes et pathologie œso-gastro-duodénale dans un service de médecine interne en milieu tropical. Médecine d ’ Afrique Noire , 39, 25‑30.
Sombié, R., Tiendrébéogo, A., Guingané, A., Hagège, H., Lesgourgues, B., Lamy, V., et al . (2015) Hémorragie digestive haute: Aspects épidémiologiques et facteurs pronostiques au Burkina Faso (Afrique de l’ouest). Journal Africain d ’ Hépato-Gastroentérologie , 9, 154-159. https://doi.org/10.1007/s12157-015-0610-z
Czernichow, P., Hochain, P., Nousbaum, J., Raymond, J., Rudelli, A., Dupas, J., et al . (2000) Epidemiology and Course of Acute Upper Gastro-Intestinal Haemorrhage in Four French Geographical Areas. European Journal of Gastroenterology & Hepatology , 12, 175-181. https://doi.org/10.1097/00042737-200012020-00007
Okon, A.J., Thot’o, A.S., Diakité, M., Soro, D., Ouattara, A., Koné, A., et al . (2015) Résultats et facteurs prédictifs de mortalité des hémorragies digestives hautes en hospitalisation: Etude multicentrique en Côte-d’Ivoire. Acta Endoscopica , 45, 285-290. https://doi.org/10.1007/s10190-015-0508-z
Razafimahefa, S., Rabenjanahary, T., Rakotozafindraibe, R., Fidinarivo, A. and Ramanampamonjy, R. (2011) Hémorragies digestives hautes : Aspects cliniques, endoscopiques et évolutifs. A propos d’une série de 62 patients malgaches. La Revue Medicale de Madagascar , 1, 6-10. https://rmm.mg/publication/8
Amouretti, M., Czernichow, P., Kerjean, A., Hochain, P., Nousbaum, J.B., Rudelli, A., et al . (2000) Management of Upper Digestive Hemorrhage Occurring in the Community: Patterns of Patient Care in 4 French Administrative Areas. Gastroentérologie Clinique et Biologique , 24, 1003‑1011.
Sim, E., Tekant, Y., Kum, C.K., Isaac, J. and Goh P. (1991) A Multimodality Approach to Endoscopic Treatment of Bleeding Peptic Ulcers. Singapore Medical Journal , 32, 415‑418.
Tchouanwou, N. and Meno, D. (2002) Les hémorragies digestives hautes en milieu hospitalier. Thèses d’exercice de médecine générale, Université de Bamako. https://www.bibliosante.ml/handle/123456789/10769
Silverstein, F.E., Gilbert, D.A., Tedesco, F.J., Buenger, N.K. and Persing, J. (1981) The National ASGE Survey on Upper Gastrointestinal Bleeding. Gastrointestinal Endoscopy , 27, 80-93. https://doi.org/10.1016/s0016-5107(81)73156-0