A Retrospective Study on the Outcome of Massive Bleeding from Peptic Ulceration

Abstract

Johansson, Catja & Båråny, F. 1973. A Retrospective Study on the Outcome of Massive Bleeding from Peptic Ulceration. Scand. J. Gastroent. 8, 113-118.

In a series of severe bleeding from peptic ulcer, the principles of selective surgery according to Avery Jones resulted in an acute mortality of 7.2 per cent. 151 patients were followed for a mean of 5.9 years after their first severe bleeding. Following gastric resection, recurrence rate of severe bleeding, was 13.4 per cent. Conservative treatment of severe bleeding from stomal ulcers was accompanied by high risk of subsequent bleeding. Vagotomy as part of the surgical procedure may reduce these recurrences. Following conservative treatment, recurrence rate of severe bleeding was 40 per cent, amounting to 62 per cent after two conservatively treated haemorrhages. It was 64 per cent for patients followed more than 10 years. A considerable mortality from recurrent bleeding was recorded. It is suggested that gastric surgery should be considered after one conservatively treated severe bleeding and strongly recommended after the second, particularly to men with duodenal ulcer, to both men and women with gastric ulcer, and to patients of low age at first bleeding.

Key-words::

• Duodenal ulcer
• haematemesis
• melaena
• stomach ulcer