Significant associations of acute gastrointestinal haemorrhage and the estimation of effectiveness of the newly proposed acute abdominal bleeding score (AABS) in emergency patients.

This study was carried out in different units of surgical wards of Khulna Medical College Hospital, Bangladesh. Among the total number of 284 patients about 88.7% (252) was admitted for the upper GIT pathology and in relation to this, lower GIT bleeding was less common 11.2% (32). In the question of emergency surgical management, 156 (61.9%) patients out of 252 upper GIT bleeding patients needed an emergency surgery, whereas it was only 12 (37.5%) out of the rest of lower GIT bleeding patients. Fortunately, in this study, it was clearly found that, in case of bleeding control, 234 (82.3%) patients had it without intervention. This study also suggests that only 29.6% (84) patients had specific clinical manifestation out of 284 patients, followed by 43% (122) who had vague signs-symptoms and the rest 27.5% (78) had latent symptoms of acute haemorrhage. In case of diagnosis of acute hemorrhagic patients, only 34.5% (98) was diagnosed clinically. A 36% (102) patient out of 284 patients was diagnosed by ultrasound of abdomen and 14.8% (42) was diagnosed by endoscopy. It was a very remarkable finding of this study that 33.8% (96) patients were remained undiagnosed till admission to first 24 hours and among 284 hemorrhagic patients, only 7.7% (22) required the emergency surgery on admission. In the type of acute episodic bleeding as well as in associated family history, some significant positive associations were found. The most important contribution of this clinical study was a very new but effective score (Acute Abdominal Bleeding Score=AABS) for the diagnosis. Also the clinical status of patients had been proposed which could be a very good tool for measuring the severity of acute abdominal hemorrhage in patients on admission (Fig. 6, Tab. 7, Ref. 46).