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KMID : 0371319730150060025
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Journal of the Korean Surgical Society
1973 Volume.15 No. 6 p.25 ~ p.33
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A Clinical Review of Non-peptic Upper Gastro-intestinal Tract Bleeding-
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薛正泫/Seul
朴正秀/朴基一/黃圭哲/Jung Hyun/Park, Jung Soo/Park, Ki Il
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Abstract
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The upper gastro-intestinal tract bleeding, especially the massive bleeding is a serious problems of the surgeons.
As we know, the prodominant disease producing upper gastro-intestinal bleeding is great prevalence in gastric or duodenal ulcer. Recently, non-peptic upper gastro-intestinal bleeding is progressively increase in occurence rate with development of new medicine.
In our report, the esophageal varix rupture bleeding among the upper gastro-intestinal bleeding noticed high incidence rate compare with foreign country, and some medicine ingestion made the massive upper Gastro-intestanl bleeding, occasionally.
A total of one hundred sixty cases of non-peptic upper gastro-intestinal tract bleeding were clinically reviewed as compare with foreigners´ report, who were admitted to Severance Hospital during eight years from Jan `64 to Dec´ 71.
The following results were.obtained:
1) The incidence of non-peptic upper gastro-intestinal bleeding was 0.448% of all patient (35657 cases) admitted to our surgical and medical department.
2) The predominal diseases producing non-peptic upper gastro-intestinal bleeding were (The most prominant upper gastro-intestinal bleeding is peptic ulcer bleeding) esophageal varices(47%), stomach Ca (15%), undetermined (15%), gastritis (11%) in this order.
3) Among 160 cases, 44 cases (28%) had massive bleeding, 74 cases (46%) had moderate bleeding and 42 cases (26%) had mild bleeding.
4) The age and sex incidence of non-peptic upper gastro-intestinal bleeding revealed a greater prevalence in male, 4th decades, with a ratio of 5 males to 1 female.
5) The history of alcohol or some medicine ingestion just before bleeding were alcohol (33 cases), aspirine (10 cases), herb medicine (5 cases), steroid (4 cases) in order.
6) Among 160 cases, 53 cases (33. 1%) were operated and 107 cases (66.9%) were not operated. The mortality rate for patients receiving surgical treatement was 25. 4% (13 cases), while for the conservatives were 46.7% (50 cases).
7) Among operated cases (53 cases), 31 cases (58. 5%) were operated in emergency, while 22 cases (41. 5%) in elective operation. Wound complication, hepatic coma, pulmonary complication, recurrent
bleeding and porto-caval encephalopathy were the most common complication after surgery, and they occured in 18 cases (34%) of the total operated cases.
8) The over all mortality rate was 39.4% (63 cases).
9) Among 63 cases of death, the cause were mainly due to hepatic coma (33 cases), surgical complication (13 cases), sustained shock (10 cases), renal failure (3 cases) in this order.
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