Abstract
A total of 51 patients with severe motor and intellectual disabilities are enrolled by small callibered transnasal endoscopy for upper gastrointestinal bleeding. The clinical backgrounds, endoscopic findings, managements and outcomes of these patients were compaired to non-bleeding group. The ages ranged from 9 to 67 years old (mean: 33.9 years). Thirty five patients had cerebral palsy and 16 had other neuromuscular diseases. Bleeding cases were 20 while 31 with non-bleeding group. No significant differences were exist between bleeding and non-bleeding groups in concern with mean age, male and female ratio, rate of anti-acid medication, complications of hiatal hernia and gastritis. Complication of reflux esophagitis was found on 55.0% in bleeding group greater than 3.2% in non-bleeding. In patients with reflux esophagitis, 8 of 12 (66.7%) were complicated by hiatal hernia but 2 of 10 (20.0%) had less positive rate of anti-Helicobacter Pylori antibody than those without esophagitis. Mild upper gastroesophageal bleeding which was well observed in severely handicapped patients was mainly caused by reflux esophagitis.
