title: Gastrointestinal bleeding in acute pancreatitis: etiology, clinical features, risk factors and outcome.
abstract: BACKGROUND
  There is paucity of data on the effect of interventions on risk of gastrointestinal bleeding (GIB) in acute pancreatitis (AP).
  
  
  METHODS
  Retrospective study of records of patients with AP and GIB.
  
  
  RESULTS
  16 (3.7%) patients (14 males; mean age 39.3 ± 12.8 years) had gastrointestinal bleeding. Two patients had peptic ulcer disease related GIB. The cause of GIB in remaining patients was: pseudoaneurysms in 5, gastrointestinal fistulization in 4, and no identifiable lesion in 5. Two patients with pseudoaneurysms were treated with angioembolisation whereas 3 needed surgery. The patients with gastrointestinal fistula had complicated course and 3 of these 4 patients died due to sepsis and multi organ failure. Rest 5 patients with no identifiable lesion were managed conservatively and there was no recurrence of GIB. Of the 14 patients with AP related GIB, a previous intervention had been done in 11(79%) patients. Fifty-three patients (12.7%) without GIB died whereas 5 (31.2%) patients with GIB succumbed to the illness (p = 0.04).
  
  
  CONCLUSIONS
  The majority of our patients of AP with GIB had antecedent history of interventions. The mortality was higher in patients with GIB, which was not due to hemorrhage but to sepsis and related complications.
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Rana
authors.forename: Vishal
authors.initials: V
authors.lastname: Sharma
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Bhasin
authors.forename: Ravi
authors.initials: R
authors.lastname: Sharma
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Puneet
authors.initials: P
authors.lastname: Chhabra
authors.forename: Mandeep
authors.initials: M
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult