The determinants of initial bleeding and rebleeding of duodenal peptic ulcers

Bratislav Lazic ,
Bratislav Lazic
Slavisa Matejic ,
Slavisa Matejic
Simon Nikolic ,
Simon Nikolic
Jasna Gacic ,
Jasna Gacic
Dragan Gacic ,
Dragan Gacic
Petar Jovanovic ,
Petar Jovanovic
Bozidar Odalovic
Bozidar Odalovic

Published: 01.01.2017.

Volume 46, Issue 1 (2017)

pp. 35-42;

https://doi.org/10.5937/pramed1702035l

Abstract

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.

Keywords

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