Treatment of acute upper gastrointestinal bleeding: a retrospective study of the results in a surgical clinic
Wiboltt, K.S.; Petersson, B.G.
European Journal of Surgery 160(6-7): 375-379
1994
ISSN/ISBN: 1102-4151 PMID: 7948357 Document Number: 426920
Objective: To review our results of the treatment of acute upper gastrcointestinal bleeding since 1990. Design: Retrospective study. Setting: District hospital. Subjects: 226 patients who presented with acute upper gastrointestinal Bleeding between January 1990 and April 1992. Interventions: Upper gastrointestinal endoscopy and, in 15 cases, emergency laparotomy. Main outcome measures: Morbidity and mortality, and the incidence of emergency operations. Results: There were 5 deaths (4%) and 11 emergency operations (10%) in 1990, compared with one death (1%) and 4 operations (4%) during the subsequent 16 months. Duration of hospital stay was reduced from a mean of 7 days to a mean of 6 days and the amount of blood transfused from a mean of 3.4 units to a mean of 2.4 (p lt 0.02) over the same period. 149 patients (66%) were over the age of 6 years, 82 (36%) were taking potentially dangerous drugs, and 129 (57%) had serious coexistent diseases. Conclusion: We conclude that the natural history of acute upper gastrointestinal bleeding may be changing, and that our "one team" approach comprising immediate resuscitation, urgent endoscopy, emergency operation when indicated, and intensive nursing, is responsible for the improvement in our results over the period of time studied.