[GASTROINTESTINAL BLEEDING IN PATIENTS ADMITTED TO THECAYETADNO HEREDIA PUBLIC HOSPITAL]

A prospective study was performed to evaluate the epidemiological characteristics, clinical outcome and to determine the cause of bleeding in patients admitted to the Cayetano Heredia National Hospital with the diagnosis of gastrointestinal bleeding. Between August 1994 and May 1995, 100 patients were admitted, 86 patients with upper gastrointestinal bleeding and 14 with lower gastrointestinal bleeding. The mean age for the former was 45,25 years and the male/female ratio was 3.5/1. The main complaints were tarry stools and haematemesis in 56,9% and 26,7% only with melena. A history of non steroidal antiinflamatory drugs intake within 48 hours before the bleeding episode was obtained in 19,7% and alcohol ingestion was observed in 19,7%. In 36% of the patients a history of a previous episode of bleeding was obtained. The major causes of bleeding were duodenal ulcer in 38,3%, acute lesions of the gastric mucosa in 20,9%, gastric ulcer in 11,6% and esophageal varices in 5,8%, Mallory Weiss syndrome in 4,6%, gastric carcinoma in 2,3%, prolapse gastropaty 2,3%, esophagitis in 2,3%, esophageal ulcer 1,1 %, duodenitis 1,1%, arteriovenus malformations in 1,1%. The etiology of the hemorrhage could not be established in 8% of cases. The diagnostic rate of endoscopy was 91,7%.In 66% of the patients the endoscopy was carried out within the 24 hours of admission 20,9% of the patients had other potential bleeding lesions 9,1% of the patients had a new episode of bleeding during hospitalization and surgery was needed in 11,6%. Injectotheraphy was done in 7 (8,13%) patients (4 for variceal 2 for duodenal and 1 for gastric bleeding ) The overall mortality was 3,4% Fourteen patients with lower gastrointestinal bleeding were evaluated. The mean age was 53,14 years and the male/female ratio was 1.6/1. The main complaint was hematochezia. The major causes of bleeding were hemorrhoidal disease in 64,2% and rectal cancer in 14,28%.