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[Upper gastrointestinal bleeding in the elderly].

K Nishida1, I Nojiri, M Kato

  • 1Department of Internal Medicine, Takagi Hospital.

Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

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Gastrointestinal bleeding in older adults is rising. Emergency endoscopy effectively diagnosed causes like gastric ulcers and cancer, guiding treatment in elderly patients experiencing hematemesis and melena.

Area of Science:

  • Gastroenterology
  • Geriatrics
  • Internal Medicine

Context:

  • Increasing prevalence of elderly individuals.
  • Rising incidence of upper gastrointestinal bleeding (hematemesis and melena) in the aged population.
  • Need for effective diagnostic and management strategies in elderly patients with gastrointestinal hemorrhage.

Purpose:

  • To evaluate the efficacy of emergency upper digestive tract endoscopy in diagnosing the causes of hematemesis and melena in patients over 60 years old.
  • To identify the spectrum of gastrointestinal pathologies responsible for bleeding in the elderly.
  • To assess the outcomes and management challenges in this patient cohort.

Summary:

  • A study of 69 elderly patients (over 60) presenting with hematemesis and melena underwent emergency endoscopy.

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  • Common diagnoses included gastric ulcer (29%), esophageal ulcer/erosion (17.4%), duodenal ulcer (13.0%), and gastric cancer (10.1%).
  • Endoscopic hemostasis was effective for diagnosis, though many patients (66.7%) required blood transfusion and (39.1%) experienced shock, often precluding surgery due to systemic deterioration.

    • Impact:

    • Emergency endoscopy is crucial for diagnosing upper gastrointestinal bleeding in the elderly.
    • Identifies common and rare causes, aiding in targeted management.
    • Highlights the high morbidity (transfusion, shock) and challenges in surgical intervention for elderly patients with GI hemorrhage.