This is a study of 257 patients with upper gastrointestinla bleeding, who were treated with conservative or surgical treatment at department of general surgery, Wallace Memorial Baptist Hospitl over a period of 5 years from January, 1987 to
December,
1991.
@ES The following results were bostatined:
@EN 1) The causative diseases were gastric ulcer(36.4%), esophagel varix(21.8%), duodenal ulcer 920.2%), stomach cancer(7.4%), hemorrhagic gastritis(6.7%), marginal gastritis(2.7%), Mallory-Weiss syndrome(1.9%) and unknown causes(4.7%).
2) The sex and age incidence of upper gastrointestinal bleeding revealed a greater prevalence in male with a ratio of 3.4 : 1 and in 6th decades(38.9%)
3) The seasonal distribution revealed a greater prevalence in Summer(33.4%).
4) The modes of upper gastrointestinal bleeding consist of hematemesis in 24.5%, melena in 17.1%, and the combination of hematemesis and melena in 58.4% of the cases.
5) The severity of upper gastrointestinal bleeding was as follows; 128 cases(49.8%) showed morderate bleeding with Hb level between 7.0 and 10.0. 80 cases931.1%) showed massive bleeding with Hb level below 7.0 and 49 cases showed minimal
bleeding
with
Hb level above 10.0.
6) The distribution of blood type was as follows; A type (33.8%), B type(27.6%), 0 type(19.5%), AB type(19.1%).
7) The amount of blood transfusion was follows; below 5 pints(39.5%), 6~10 pints(30.8%), 11~15 pints(17.5%), 16~10 pints(9.7%) and above 21 pints(2.7%).
8) Upper G-I series were performed on 115 cases(44.7%) with the diagnostic accuracy of 73.9% and edoscopy on 199 cases977.4%) with the accuracy of 92.5%.
9) Conservative treatment was done in 95 cases937.0%) and operative treatment in 162 cases (63.0%). The most common operative procedure was subtotal gastrectomy and the next was vagotomy and antrectomy.
10) Postoperative complications were found in 60 cases(37.0%) and pulmonary complication was the most frequent complication, followed by wound infection, hepatic coma, rebleeding, urinary tract infection, renal failure, subphrenic abscess,
leakage
and
sepsis.
11) The overall mortality rate was 12.1% (31 case). The mortality rate of the patients treated surgically was 4.9% (13 cases) while it treated conservatively was 18.9%(19 cases). The main causes of death were hepatic coma, shock, renal failure
and
sepsis.
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