eat: 12 cases; Duodenal seat: 6 fish case.

digestive endoscopy and the causes of the bleeding did not reported in theses cases. We collected 63 cases of upper gastrointestinal bleeding, which accounted for 6.7% of hospitalizations over an 11-month period. This frequency is considerable in a context where the means of haemostasis (pharmacological and endoscopic) are not available. However, the data collected made it possible to evaluate the epidemiology, the clinical picture, the etiologies and the prognosis of these haemorrhages. This frequency is similar to those found by Diarra et al. [13] and Bagny et al. [9] which were respectively 5.55% and 7.32%, but higher than those found in some African studies between 2% and 3%, 6% [6] [7] [8] [10] .

These differences in frequency can be explained by a recruitment bias because of the durations of the studies are not identical.

The male predominance of gastrointestinal bleeding is reported in several African series [6] [7] [8] [9] [11] [13] [15] probably related to the easy access of men to the toxic (tobacco, NSAID). In addition, the high incidence of PHT-producing liver disease is reported in humans [11] .

The average age of occurrence of gastrointestinal bleeding in our study (45 years) is similar to that of some African studies that were 48 years [6] and 47.45 years [13] but lower than that found by Zohra 51 years [16] .

The high prevalence among farmers and housewives could be explained by the promiscuity that favors the human-to-human transmission of the hepatitis B virus. This fact is justified by the frequency of EV rupture caused by PHT in relation to cirrhosis. B. Horizontal transmission, horizontal transmission, inter-individual of this virus is known. Tobacco was the most recovered toxicant with 22.3% of cases and could intervene in the determinism of PU frequently found in this study and explained the male predominance. The gastro-toxic drugs were found in our study in 6.3% of cases comparable to the frequency of Razafimahefa et al. which was 7.6% [8] but lower than that of Bagny et al. which was 17% [9] . The signs of intolerance of anemia were found in most of our patients and this finding was reported by N’Tagirabiri et al. [15] and Razafimahefa et al.

Rupture of oesophageal varices was the leading cause of upper digestive haemorrhage found in 57.6% of cases followed by peptic ulcer with 30.5% of cases, most likely because of the frequency of infection with the gastrointestinal ulcer HBV and Helicobacter pylori infection in the general population. This finding confirms the study by Diarra et al. [13] who found respectively 55.2% and 12.8%. These results are different from those of N’Tagirabiri et al. (28.2% and 46.1%) [15] and Razafimahefa et al. [8] who found 40.32% PU and 38.76 indeterminate causes. In our study, no lesion in digestive endoscopy was found in 3.4% of cases, probably due to fugitive lesions by NSAIDs justifying the early inputs of endoscopy.

Rupture of oesophageal varices was the leading cause of upper digestive haemorrhage found in 57.6% of cases followed by peptic ulcer with 30.5% of cases, most likely because of the frequency of infection with the gastrointestinal ulcer. HBV and Helicobacter pylori infection in the general population. This finding confirms the study by Diarra et al. [13] who found respectively 55.2% and 12.8%. These results are different from those of N’Tagirabiri et al. (28.2% and 46.1%) [15] and Razafimahefa et al. [8] who found 40.32% PU and 38.76 indeterminate causes. In our study, no lesion in digestive endoscopy was found in 3.4% of cases, probably due to fugitive lesions by NSAIDs justifying the early inputs of endoscopy.

In 39 patients, a transfusion was indicated but it did not influence the prognosis (p = 0, 8308). The same observation was made by Maiga et al. [14] . The immediate course was favorable in 73% of the cases after a resuscitation associating with a vascular filling, an administration of PPI, an antibiotherapy, the hemostatic treatment not being available. This rate is not identical with those of Diarra et al. [13] and N'Tagirabiri et al. [15] which were respectively 77.6% and 77.1%.

The mortality of digestive haemorrhages in our series was 14.3%. Higher mortality was reported by Diarra et al. (22.4%) [13] and N’Tagirabiri et al. (22.9%) [15] .

This mortality is linked in our series to the early recurrence of hemorrhage and also to the most often cirrhotic terrain whereas for Diarra et al. [13] and Razafimahefa et al. [8] it seems to be linked to certain lesions, in particular gastric tumors and rupture of oesophageal varices.

5. Conclusion

Acute high digestive hemorrhages remain frequent and serious in our context. The availability of specific hemostatic treatment could have reduced overall mortality. In addition, the prevention of infection with hepatitis viruses and the fight against self-medication could reduce the frequency and therefore the mortality of these accidents.

Cite this paper
Dicko, M. , Samake, D. , Coulibaly, S. , Soumaré, G. , Tounkara, M. , Katilé, D. , Mallé, O. , Guindo, H. , Sidibé, S. , Maiga, A. , Konate, A. , Diarra, M. and Maiga, M. (2018) Acute Upper Digestive Bleedings in Hospital in Bamako. Open Journal of Gastroenterology, 8, 387-393. doi: 10.4236/ojgas.2018.811040.
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