الفهرس 
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Abstract
acute upper gastrointestinal hemorrhage (UGH) is a prevalent, clinically significant, and expensive healthcare problem. Acute UGIH is categorized as non-variceal or variceal, depending on the etiology. The vast majority of acute UGIH is secondary to variceal causes especially in Egypt. In the developed countries peptic ulcers being the most prevalent cause followed by gastroduodenal erosions, Mallory-Weiss tear, esophagitis, and Dieulafoy’s lesions. Hematemesis, and melena, are the primary clinical symptoms indicate of UGIH. The main goal of management, is to identify patients at high risk for an adverse outcome on the basis of clinical, laboratory, and endoscopic variables.
Initial management should be immediate evaluation, and resuscitation, including stabilization of blood pressure, and restoration of intravascular volume. Nasogastric aspiration, is routinely performed in patients with UGIH, to obtain important clinical data, and make therapeutic decisions. But routine use of NGA remains controversial, with studies reporting its usefulness, and its redundant clinical information. The use of vasopressors and proton pump inhibitors before, and after endoscopy, was said to be useful than using NGA. In this study we attempt to discuss these controversies, and reach some general conclusions as to the role of vasoactive drugs, and NGT in acute upper gastrointestinal bleeding. This study included (88) patient with variceal bleeding and (60) patients with peptic ulcer cause of bleeding who fulfilled the inclusion criteria from emergency gastrointestinal unit, Internal Medicine Department, Zagazig University Hospital.
All patients were subjected to: thorough history taking, and thorough physical examination, laboratory investigations, and upper esophago-gastroduodenoscopy within 24 hrs, post endoscopic followup including vital signs, enema, rebleeidng and encephalopathy.