Acute bleeding of the upper gastrointestinal tract is an urgent condition with high morbidity, and a significant mortality despite advanced diagnostics and therapy. The goal is to investigate the determinants of the severity of duodenal peptic ulcer bleeding. The research included 304 patients hospitalized for acute bleeding from the upper part of gastrointestinal tract in a five year period. They had been treated in the Clinical Hospital Center Bežanijska Kosa in Belgrade. The diagnosis was made via gastroduodenoscopy. Out of the 304 patients, 197 (65%) suffered from bleeding peptic ulcer. 144 (73,1%) patients suffered from bleeding duodenal ulcer, most frequently with bulbar localization 124/86 (12%); 78 (62,9%) with a duodenal bulb back wall lesion. 48 (35,1%) of the bleeding duodenal ulcers were in the Forrest Ib stage, in 68 (47,2%) patients the size of the ulcer lesion was between 1,1-2,0 cm. A statistically positive correlation was determined between the duodenal ulcer lesions and the intensity of the bleeding (p<0,005). With 68/79/86,1% patients treated endoscopically, haemostasis was successful, whereas in 13/19,1%, rebleeding was localized in 11/84,6% in the duodenum bulb bask wall.
Van Leerdam M. Epidemiology of acute upper gastrointestinal bleeding. Clin Gastroenterol. 2008;422–9.
2.
Laine L, Peterson W. Bleeding peptic ulcer. N Engl J Med. 1994;717–26.
3.
Enestvedt B, Gralnek I, Mattek N, Lieberman D, Eisen G. An evaluation of endoscopic indications and findgins related to nonvariceal upper-GI hemorrhage in a large multicenter consortium. Gastrointest Endose. 2008;422–9.
4.
Lau J, Sung J, Hill C, Henderson C, Howden C, Metz D. Sistematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion. 2011;(2):102–13.
5.
Vreeburg E, Snel P, De Bruijne J, Bartelsman J, Rauws E, Tytgat G. Acute upper gastrointestinal bleeding in the Amsterdam area: incidence, diagnosis, and clinical outcome. Am J Gastroenterol. 1997;236–43.
6.
Ahsberg K, Yew, Lu Y, Zheng Z. Steal von Holstein C. Hospitalization of and mortality from bleeding peptic ulcer in Sweden: a nationwide time trends analysis. Aliment Pharmacol Ther. 2011;(5):578–84.
7.
Forrest J, Finlayson N, Shearman D. Endoscopy in gastrointestinal bleeding. Lancet. 1974;(7877):394–7.
8.
Milosavljevi T, Kosti -Milosavljevi M, Jovanovi I, Krsti M. Complications of peptic ulcer disease. Dig Dis. 2011;(5):491–3.
9.
Gralnek I, Barkun A, Bardon M. Management of acute bleeding from a peptic ulcer. N Engl J Med. 2008;(9):928–37.
10.
Levine M. Peptic ulcers. 2000;314–45.
11.
Church N, Palmer K. Ulcers and nonvariceal bleeding. Endoscopy. 2003;(1):22–6.
12.
Chung IK, Ho Lee D, Kim HU, In, Sung K, Kim JH. Korean Collegeof Helicobacter and Upper Gastrointestinal Research, and Korean Association of Gastroenterology. Guidelines of Treatment for Bleeding Peptic Ulcer Disease. Korean Journal Gastroenterol. 2009;298–308.
13.
Andersen I, Bonnevieo, Jergensen T, Serensen T. Time trends for peptic ulcer disease in Denmark, 1981-1993. Analysis of hospitalization register and mortality data. Scand J Gastroenterol. 1998;(3):260–6.
14.
Langman M, Aetiology. 1987;268–81.
15.
Ljubi I N, Pavi T, Budimir I, Puljiz Ž, Biš Anin A, Bratani A, et al. North vs South differences in acute peptic ulcer hemorrhage in Croatia: hospitalization incidence trends, clinical features, and 30-day case fatality. Croat Med J. 2014;(6):647–54.
16.
Rigopoulos S, Ramboin I, Georgescu. A critical evaluation of Surgical Treatment of Perforated Ulcer. Current Health Siences Journal. 2011;(2):75–8.
17.
Marcel J, Groenen E, Kuipers B, Hansen RJT, Ouwendijk. Incidence of duodenal ulcers and gastric ulcers in a Western population: Back to where it started. Can J Gastroenterol. 2009;(9):604–8.
18.
Christensen S, Riis A, Norgaard M, Sorensen H, Thomsen R. Short term mortality after perforated or bleeding peptic ulcer among elderly patients: a population based cohort study. BMC Geriatrics. 2007;8.
19.
Van Leerdam M, Vreeburg E, Rauws E, Geraedts A, Tijssen J, Reitsma J. Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol. 2003;(7):1494–9.
20.
Segal W, Cello J. Hemorrhage in the upper gastrointestinal tract in the older patient. Am J Gastroenterol. 1997;(1):42–6.
Barkun A, Bardon M, Kuipers E, Sung J, Hunt R, Martel M, et al. International Consensus Upper Gastrointestinal Bleeding Conference Group. International Consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2010;(2):101–13.
23.
Spiegel B, Vakil N, Ofman J. Endoscopy for acute nonvariceal upper gastrointestinal tract hemorrhage: is sooner better? A systematic review. Arch Int Med. 2001;(11):1393–404.
24.
Bjorkman D, Zaman A, Fennerty M, Lieberman D, Disario J, Warnick G, et al. Urgent vs elective endoscopy for acute non varices upper GI bleeding: an effectiveness study. Gastrointest Endosc. 2004;(1):1–8.
25.
Hearnshaw S, Logan R, Lowe D, Travis S, Murphy M, Palmer K. Use of endoscopy for management of acute upper gastrointestinal bleeding in the UK: results of a nationwide audit. Gut. 2010;(8):1022–9.
26.
Waquar Uddin A, Qureshi H, Ejaz Alam S, Sarwar Jehan Zuberi. Site of duodenal ulcer and its influence on the mode of presentation and prognosis. JPMA. 1990;238.
27.
Barkun A, Sabbah S, Enns R, Armstrong D, Gregor J, Fedorak R, et al. The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): Endoscopic Haemostasis and proton pump inhibition are associated with improved outcomes in a real life setting. Am J Gastroenterol. 2004;(7):1238–46.
28.
Elkin W. Diagnostic problems in cases of large or giant duodenal ulcer. Radiology. 1941;748–50.
29.
Rathi P, Parikh S, Kalro R. Giant duodenal ulcer: a newlook at a variant of a common illness. Indian J Gastroenterol. 1996;(1):33–4.
30.
Brdiczka J. Das Grosse ulcus duodeni in rontenbild. Fortschr Geb Rontgenstr. 1931;177–81.
31.
Patel D, Dodia H. Pre Operative Factors Affecting Outcome in Cases of Peptic Perforation. International Journal of Science and Research. 2015;(8):181–6.
32.
Gupta S, Kaushik R, Sharma R, Attri A. The management of large perforations of duodenal ulcers. BMC Surg. 2005;15.
33.
Rajesh V, Chandra S, Smile S. Risk factors predicting operative mortality in perforated peptic ulcer disease. Trop Gastroenterol. 2003;(3):148–50.
34.
Lunevicius R, Morkevicius M. Perforated duodenal ulcer: benefits and risk of laparoscopic repair. 2004;(6):522–37.
35.
Guglielmi A, Ruzzenente M, Sandri R, Kind F, Lombardo L, Rodella F, et al. Risk Assessment and Prediction of Rebleeding in Bleeding Gastroduodenal. Endoscopy. 2002;(10):771–9.
36.
Ljubi I N, Puljiz Z, Budimir I, Biš Anin A, Bratani A, Pavi T, et al. The influence of aethyologic factors on clinical, outcome in patients with peptic ulcer bleeding. Dig Dis. 2012;(12):3195–204.
37.
Jensen D. The bleeding ulcer-stigmata, probes and antibiotics? ASGE Postgraduate Sourse Digestive Disease Week (DDW) 1997. :23–4.
38.
Park K, Steele R, Mollison J. Prediction of reccurent bleeding after endoscopic haemostasis in nonvariceal upper gastrointestinal haemorrhage. Br J Surg. 1994;1465–8.
39.
Bratislav TDOIBARODPU. Petar Jovanovic1, Božidar Odalovic1 1 Surgical clinic, Medical Faculty Pristina, Kosovska Mitrovica 2 Clinic of Radiology, Medical Faculty Pristina, Kosovska Mitrovica 3 Surgical clinic, Clinical Hospital Center Bezanijska Kosa, Belgrade SUMMARY Acute bleeding of the upper gastrointestinal tract is an urgent condition with high morbidity, and a significant mortality despite advanced diagnostics and therapy. The goal is to investigate the determinants of the severity of duodenal peptic ulcer bleeding. The research included 304 patients hospitalized for acute bleeding from the upper part of gastrointestinal tract in a five year period. They had been treated in the Clinical Hospital Center Bežanijska Kosa in Belgrade. The diagnosis was made via gastroduodenoscopy. Out of the 304 patients, 197 (65%) suffered from bleeding peptic ulcer. 144 (73,1%) patients suffered from bleeding duodenal ulcer, most frequently with bulbar localization. (86).
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
