[The changing clinical picture of gastroduodenal ulcer disease]

The authors evaluate the changing clinical picture of gastroduodenal ulceration in recent years.

They analysed their own clinical material from January 1994 till April 1998 when at the Second Surgical Clinic in Olomouc 188 patients were hospitalised on account of gastroduodenal ulceration.

The group of patients comprised a high proportion of patients above 60 years of age (102, i.e. 55%) and twice as many cases of duodenal ulcers as compared with gastric ones. In 4% ulcers were present at both sites. In 92% (173 patients) acute admissions were involved and only in 8% (15 patients a planned admission for elective treatment was involved. As to complications haemorrhage was most frequent (84%), perforations in 13% and pylorostenosis in 3%. Of the acute admissions 56 patients were operated, i.e. 32%, the rest were treated by conservative methods. The surgical lethality was 12%, the lethality of the conservatively treated patients 5%.

Gastroduodenal ulceration is at present characterised by a predominance of conservative treatment, a decline of elective operations, a high percentage of complications in particular in advanced age, more frequent affection of the duodenum and late indication for surgery, when conservative treatment is not very successful.