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KMID : 0371319760180090043
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Journal of the Korean Surgical Society
1976 Volume.18 No. 9 p.43 ~ p.50
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Clinical Observation fur Upper Gastrointestinal Tract Hemorrhage
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徐廷彦/SUH, J.E.
洪起雄/鄭巴琮/崔光林/Hong, K.U./Jung, P.J./Choi, K.L.
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Abstract
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Upper gastrointestinal tract hemorrhage, is bleeding from upper end of esophagus to Treitz ligament, This phenomenon is terrifying experience for the patient and an urgent challenge to the surgeon.
Recently despite early diagnosis, the best treatment and the widespread use of whole blood, patients with upper gastrointestinal tract hemorrhage continue to have- mortality of more than 10 percents.
Duodenal ulcer has been well established as the most common cause; of upper gastrointestinal bleeding, It is followed in order of relative frequency by gastric ulcer, stomach cancer esopha-geal varix rupture, gastritis, hiatal hernia etc.
Clinical observation on 104 patients with upper gastrointestinal tract hemorrhage who were admitted to the-Department of Surgery, Han Yang University Hospital, from May 1972 to May 1975, has been analyzed and summarized as follows:
1. The causative diseases inducing, upper gastrointestinal tract hemorrhage were, 32 cases of duodenal ulcer (30,7%), 24 cases of, gastric, ulcer, (23%), 12 cases of esophageal varix rupture (11.5´%), 20 cases of stomach cancer (19.2%) gastritis (6.7%) and 8-cases of others.
2. Sex incidence revealed a greater; prevalence in male, with ratio of 15:1 and in age incid-ence, on 4th-6th decade was peaked.
3.On bleeding picture, hematemesis only was noted in -38 cases (36%), melena only in 24 cases (23%) and combined hematemesis and melena in 42 cases (41%).
4. On blood loss, massive blood loss was 58 cases (55.5%), moderated loss was39 cases (38%) and mild loss was Teases (8%).
5. Among 104 cases 77 cases (74%) were treated surgically and 27 cases (26%) were conservatively.
6. Mortality rate was 36.6 percent in conservative group and 11.6 percent in surgical group. The overall mortality rate was 18.2 percent
7. Postoperative complication and or causes of death were, continued renal failure (3 cases), heapic coma (2 cases), electrolyte imbalance (2. cases), uncontrolled bleeding (1 case) and pulmonary complication (l case).
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