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Massive upper gastrointestinal bleeding after acid-corrosive injury
Yau-Lin Tseng1, Ming-Ho Wu, Mu-Yen Lin
1Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
World Journal of Surgery
|December 3, 2003
Summary
Massive upper gastrointestinal bleeding from acid-corrosive injury is rare but serious, typically occurring in the subacute stage. Aggressive surgery is crucial for gastric bleeding, while duodenal bleeding management needs further investigation.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Trauma Surgery
Background:
- Acid-corrosive injury can lead to severe gastrointestinal complications.
- Massive upper gastrointestinal bleeding (UGI) is a rare but life-threatening sequela.
Purpose of the Study:
- To characterize massive UGI bleeding following acid-corrosive injury.
- To determine optimal management protocols for this condition.
Main Methods:
- Retrospective review of patients with acid-corrosive injury from June 1988 to June 2000.
- Inclusion criteria: massive UGI bleeding (hematocrit <25% or >3 units of blood transfusion).
Main Results:
- 12 (3.2%) of 378 patients experienced massive UGI bleeding.
- Gastric bleeding occurred earlier (average 12.1 days post-injury) and predominantly required surgery.
- Duodenal bleeding occurred later and had a higher complication rate with mixed surgical and conservative management.
Conclusions:
- Massive UGI bleeding post-acid injury is a subacute event.
- Surgical intervention is essential for gastric bleeding.
- Optimal management for duodenal bleeding requires further research.