From Portal Hypertension to Peptic Ulcer Disease: An Overview of Upper Gastrointestinal Bleeding in Agadir

Upper gastrointestinal bleeding (UGIB) is a frequent and serious gastroenterological emergency, representing a major cause of morbidity and mortality. To describe its clinical, etiological, therapeutic, and prognostic characteristics in our context, a retrospective study was conducted at the Regional Hospital Center of Agadir over a six-year period (2015–2020), including 549 patients hospitalized for UGIB. Clinical, biological, endoscopic, and outcome data were collected and analyzed. The mean age of patients was 49 years with a male predominance. The main presenting symptoms were hematemesis (70%) and melena (13%). Anemia was frequently observed, requiring blood transfusion in more than 60% of cases. Endoscopy was performed within 24 hours in 60% of patients and identified portal hypertension (43%), mainly due to esophageal varices, and peptic ulcer disease (17%), often associated with non-steroidal anti-inflammatory drug intake, as the leading causes. Management combined medical treatment (proton pump inhibitors, vasoactive drugs) and endoscopic procedures (elastic band ligation, injection, clipping) depending on the etiology. In-hospital mortality was 6.2% in patients with portal hypertension and 7.3% in those with ulcer disease. Multivariate analysis identified advanced age, male sex, and severe anemia as independent predictors of death. In conclusion, UGIB in Agadir affects a relatively young population and is still dominated by variceal bleeding related to cirrhosis and ulcer disease linked to NSAIDs. Rapid multidisciplinary management and improved access to hemostatic endoscopy, together with preventive measures such as hepatitis vaccination and rational NSAID use, are essential to improve prognosis.