A total 111 cases of upper gastrointestinal bleeding and perforation admitted to the Dept. of surgery of Korea University Hospital during June 1974 to Oct. 1976 were clinically reviewed. The following results were obtained.
1. seventy-seven cases were massive upper G-I bleeding and 34 cases were upper G-I perforation.
And the ratio of upper G-I bleeding to perforation was 2.3 : 1.
Also, bleeding was much more frequent in the stomach and perforation in the duodenum.
2. The age incidence revealed a greater prevalence on 4 th-6_th decade (70.1%) in the bleeding case, and on 3 rd~5th decade (73.5%) in the- perforation case.
The sex distribution was 4..8: 1, with male (92) female (19).
3. Incidence on seasonal distribution was high in Spring and Autumn.
4. In past history, indigestion and postprandial epigastric pain were as most common symptoms
(73%), and no any symptoms and signs were´ noted in 13.6% of total patients.
5. Duration of symptoms were within 2 months (27%) and within 1~3 years (19.8%).
6. The most common type of blood in gastric bleeding and perforation cases was type 0, and in duodenal bleeding and perforation cases was type A.
7. On hematologic finding, abnormal hemoglobin level in the bleeding case was noted in 63.6
%. Also, abnormal L.F.T. finding was noted in 9.8% of the bleeding case.
8. Upper G-I series revealed pathologic ulcer lesion in 67.3% of the bleeding case. In the perforation group, subdiaphragmatic free gas was noted in 76.5%.
9. In the bleeding cases, bleeding due to gastric ulcer was more predominant. Also, in the perforation cases, perforation due to duodenal ulcer was more predominant.
10. Twenty seven point three percent of the bleeding cases were treated nonoperatively and
42.9% of those patients had poor result.
The following surgical procedure had applied for bleeding acute mucosal lesion; subtotal gastrectomy (72.7%), vagotomy and pyloroplasty (9.1%), near total gastrectomy. (9.1%), multiple ligation (9.1%).
In cases of bleeding gastric ulcer, subtotal gastrectomy (82.2%), vagotomy and pyloroplasty (7. 1%), suture ligation (7. 1%), wedge resection (3.6r%) were used.
In comparison to A.G.M. and gastric ulcer bleeding, vagotmyand and pyloroplasty (28.6%) were more frequently used and subtotal gastrectomy (50%) and suture ligation (21.40 were used in high incidence.
For perforation, 4 cases of subtotal gastrectomy were used for stomach, and vagotomy with pyloroplasty (50%), simple closure (33.3%), subtotal gastrectomy (16.7%) were performed for duodenum.
11. The postoperative complications were 19.8%. Among these, wound infection was most frequent (31.8%).
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