Skip to main content
SpringerLink
Log in

Ulcères gastroduodénaux hémorragiques : étude prospective observationnelle multicentrique en Côte-d’Ivoire

Bleeding peptic ulcers: Multicenter prospective observational study in Côte-d’Ivoire

  • Article Original / Original Article
  • Published:
Acta Endoscopica

Résumé

Buts

Décrire la prise en charge et le pronostic des hémorragies ulcéreuses gastroduodénales en Côted’Ivoire.

Patients et méthodes

Étude multicentrique (trois centres hospitaliers universitaires du 1er janvier 2010 au 30 septembre 2013). De multiples données cliniques, biologiques et endoscopiques ont été recueillies de façon prospective. Résultats: Quatre-vingt-trois patients ont été recrutés

Résultats

Quatre-vingt-trois patients ont été recrutés (âge moyen: 49 ans; sex-ratio: 5, 4; comorbidités: 5, 4 %; prise d’un anti-inflammatoire non stéroïdien dans 26, 5 % des cas [automédication]). Une transfusion était faite dans 85, 5 % des cas (hémoglobine < 7 g/dl chez 71 patients). Un inhibiteur de la pompe à protons (IPP) a été prescrit chez tous dès l’admission. La gastroscopie (avant 24 heures dans 34, 9 % des cas) a retrouvé un ulcère principalement duodénal (67, 5 %). Le score de Forrest était à III (67 %), celui de Rockall inférieur à 5 (94 %). Aucune hémostase endoscopique n’a été réalisée. Seuls 2, 4 % des patients (tous de stade IIB) ont récidivé. Tous les patients ont été hospitalisés (durée moyenne: sept jours) et ont eu un traitement d’éradication d’Helicobacter pylori (Hp), aucun n’est décédé.

Conclusion

Le traitement essentiellement médical est efficace, les patients étant à faible risque. Nos hôpitaux doivent être équipés en matériel d’hémostase endoscopique pour ceux à haut risque.

Abstract

Aims

To describe management and prognosis of peptic ulcer bleeding in Côte-d’Ivoire.

Patients and methods

This was a multicenter study at three university hospitals from January 1st, 2010 to September 30rd, 2013. Multiple clinical, laboratory, and endoscopic parameters were collected prospectively.

Results

A total of 83 patients (mean age: 49 years; sex ratio: 5.4) were studied. They had comorbidities in 5.4% or used a non-steroidal anti-inflammatory drug in 26.5% of cases (self-medication). Transfusion was made in 85.5% of cases (hemoglobin < 7 g/dl in 71 patients). A proton pump inhibitor was prescribed to all upon admission. Peptic ulcer located in the duodenum was found in 67.5% of cases during gastroscopy (realized before 24 hours in 34.9% of cases). The Forrest classification and the Rockall scores were respectively 3 (67%) and less than 5 (94%). No endoscopic hemostasis was performed. Only 2.4% (N = 2) of patients (all in stage IIB) recurred bleeding ulcer. All patients were hospitalized (average duration of 7 days) and had an eradication of Helicobacter pylori, none died.

Conclusion

The medical treatment is effective when patients are at low-risk. Our hospitals must be equipped in endoscopic hemostasis material for those at high-risk in an emergency unit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Lesur G, Camus M. Comment optimiser la prise en charge endoscopique des hémorragies digestives hautes. Acta Endosc 2015;45:151–5

    Article  Google Scholar 

  2. Sheasgreena C, Leontiadis GI. Recent advances on the management of patients with non-variceal upper gastrointestinal bleeding. Ann Gastroenterol 2013;26:191–7

    Google Scholar 

  3. Nahon S, Hagège H, Latrive JP, et al. Epidemiological and prognostic factors involved in upper gastrointestinal bleeding: results of a French prospective multicenter study. Endoscopy 2012; 44:998–1008

    Article  PubMed  CAS  Google Scholar 

  4. Gralnek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med 2008;359:928–37

    Article  PubMed  CAS  Google Scholar 

  5. Sung JJ, Tsoi KK, Ma TK, et al. Causes of mortality in patients with peptic ulcer bleeding: a prospective cohort study of 10, 428 cases. Am J Gastroenterol 2010;105:84–9

    Article  PubMed  Google Scholar 

  6. Bagny A, Bouglouga O, Djibril MA, et al. Profil étiologique des hémorragies digestives hautes de l’adulte au CHU campus de Lomé (Togo). J Afr Hepatol Gastroenterol 2012;6:38–42

    Article  Google Scholar 

  7. Ntagirabiri R, Mumana A, Dunduri D, et al. Hémorragie digestive haute de l’adulte au Burundi: aspects épidémiologiques, étiologiques, thérapeutiques et évolutifs. J Afr Hepatol Gastroenterol 2012;6:272–5

    Article  Google Scholar 

  8. Alatise O, Aderibigbe AS, Adisa AO, et al. Management of overt upper gastrointestinal bleeding in a low resource setting: a real world report from Nigeria. BMC Gastroenterol 2014;14:210–5

    Article  PubMed  PubMed Central  Google Scholar 

  9. Diarra M, Soucko-Diarra A, Dolo M, et al. Hémorragies digestives hautes aiguës: expérience d’un milieu rural. Acta Endosc 2007;37:321–6

    Article  Google Scholar 

  10. Alema ON, Martin DO, Okello TR. Endoscopic findings in upper gastrointestinal bleeding patients at Lacor hospital, Northern Uganda. Afr Health Sci 2012;12:518–21

    PubMed  PubMed Central  CAS  Google Scholar 

  11. van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 2008;22:209–24

    Article  PubMed  Google Scholar 

  12. Hreinsson JP, Kalaitzakis E, Gudmundsson S, Björnsson ES. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scand J Gastroenterol 2013;48:439–47

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Loperfido S, Baldo V, Piovesana E, et al. Changing trends in acute upper GI bleeding: a population-based study. Gastrointest Endosc 2009;70:212–24

    Article  PubMed  Google Scholar 

  14. Jairath V, Kahan BC, Gray A, et al. Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial. Lancet 2015;14:61999–1

    Google Scholar 

  15. Cheng HC, Sheu BS. Intravenous proton pump inhibitors for peptic ulcer bleeding: clinical benefts and limits. World J Gastrointest Endosc 2011;3:49–56

    Article  PubMed  PubMed Central  Google Scholar 

  16. van Rensburg CJ, Hartmann M, Thorpe A, et al. Intragastric pH during continuous infusion with pantoprazole in patients with bleeding peptic ulcer. Am J Gastroenterol 2003;98:2635–41

    Article  PubMed  Google Scholar 

  17. Al Dhahab H, McNabb-Baltar J, Al-Taweel T, Barkun A. Stateof- the-art management of acute bleeding peptic ulcer disease. Saudi J Gastroenterol 2013;19:195–204

    Article  PubMed  PubMed Central  Google Scholar 

  18. Barkun AN. Should every patient with suspected upper GI bleeding receive a proton pump inhibitor while awaiting endoscopy? Gastrointest Endosc 2008;67:1064–6

    Article  PubMed  CAS  Google Scholar 

  19. Sheasgreena C, Leontiadis GI. Recent advances on the management of patients with non-variceal upper gastrointestinal bleeding. Ann Gastroenterol 2013;26:191–7

    Google Scholar 

  20. Barkun AN, Bardou M, Ernst J. International consensus recommendations on the management of patients with non-variceal upper gastrointestinal bleeding. Ann Intern Med 2010;152:101–13

    Article  PubMed  Google Scholar 

  21. Adamsen S, Bendix J, Kallehave F, et al. Clinical practice and evidence in endoscopic treatment of bleeding peptic gastroduodenal ulcer. Scand J Gastroenterol 2007;42:318–23

    Article  PubMed  Google Scholar 

  22. Lanas A, Carrera-Lasfuentes P, García-Rodríguez L, et al. Outcomes of peptic ulcer bleeding following treatment with proton pump inhibitors in routine clinical practice: 935 patients with high- or low-risk stigmata: Scand J Gastroenterol 2014;49:1181–90

    Article  PubMed  CAS  Google Scholar 

  23. Lodato F, Azzaroli F, Turco L, et al. Adverse effects of proton pump inhibitors. Best Pract Res Clin Gastroenterol 2010;24: 193–201

    Article  PubMed  CAS  Google Scholar 

  24. Muguruma N, Kitamura S, Kimura T, et al. Endoscopic management of non-variceal upper gastrointestinal bleeding: State of the Art Clin Endosc 2015;48:96–101

    Article  Google Scholar 

  25. Jairath V, Kahan BC, Logan RF, et al. Outcomes following acute non-variceal upper gastrointestinal bleeding in relation to time to endoscopy: results from a nationwide study. Endoscopy 2012; 44:723–30

    Article  PubMed  CAS  Google Scholar 

  26. Kim JS, Park SM, Kim BW. Endoscopic management of peptic ulcer bleeding. Clin Endosc 2015;48:106–11

    Article  PubMed  PubMed Central  Google Scholar 

  27. Benajah DA, Aqodad N, ElFakir S, et al. Les hémorragies digestives ulcéreuses au CHU Hassan-II de Fès: approche épidémiologique. J Afr Hepatol Gastroenterol 2009;3:16–21

    Article  Google Scholar 

  28. Levin DA, Watermeyer GA, Deetleefs E, et al. The efficacy of endoscopic therapy in bleeding peptic ulcer patients. S Afr Med J 2012;102:290–3

    PubMed  Google Scholar 

  29. Samlani-Sebbane Z, · Gharaba S, Krati K, et al. Le profil étiologique des hémorragies digestives hautes extériorisées dans la région de Marrakech. J Afr Hepatol Gastroenterol 2012;6:256–8

    Article  Google Scholar 

  30. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol 2012;107:345–60

    Article  PubMed  CAS  Google Scholar 

  31. Barkun AN, Martel M, Toubouti Y, et al. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointesc Endosc 2009;69:786–99

    Article  Google Scholar 

  32. Sánchez-Delgado J, Gené E, Suárez D, et al. Has Helicobacter pylori prevalence in bleeding peptic ulcer been underestimated? A meta-regression. Am J Gastroenterol 2011;106:398–405

    Article  PubMed  Google Scholar 

  33. Gisbert JP, Calvet X, Cosme A, et al. Long-term follow-up of 1, 000 patients cured of Helicobacter pylori infection following an episode of peptic ulcer bleeding. Am J Gastroenterol 2012; 107:1197–204

    Article  PubMed  CAS  Google Scholar 

  34. Gado AS, Ebeid BA, Abdelmohsen AM, Axon AT. Clinical outcome of acute upper gastrointestinal hemorrhage among patients admitted to a government hospital in Egypt. Saudi J Gastroenterol 2012;18:34–9

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de médecine et de gastroentérologie, CHU Cocody, Cocody, France

    C. Assi, A. Ouattara, A. Coulibaly, D. Soro, E. Allah-Kouadio, M. J. Lohouès-Kouacou & B. M. Camara

  2. Service de gastroentérologie, CHU de Bouaké, Bouaké, France

    S. A. Thot’o & M. Diakité

  3. Service de gastroentérologie, CHU de Yopougon, Yopougon, France

    M. F. Bathaix, S. Doffou, Y. H. Kissi, D. Bangoura, K. A. Attia & T. Ndri-Yoman

Authors
  1. C. Assi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. A. Thot’o
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Diakité
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. F. Bathaix
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Doffou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Ouattara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y. H. Kissi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Coulibaly
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. D. Bangoura
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. D. Soro
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. E. Allah-Kouadio
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. K. A. Attia
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. M. J. Lohouès-Kouacou
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. T. Ndri-Yoman
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. B. M. Camara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Assi.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Assi, C., Thot’o, S.A., Diakité, M. et al. Ulcères gastroduodénaux hémorragiques : étude prospective observationnelle multicentrique en Côte-d’Ivoire. Acta Endosc 45, 297–301 (2015). https://doi.org/10.1007/s10190-015-0516-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10190-015-0516-z

Mots clés

Keywords

Search

Navigation