[Diagnosis and treatment of gastrointestinal hemorrhage]

The article analyses the results of treatment of 4,430 patients with gastrointestinal bleeding in the last four decades. Two periods, from 1950 to 1969 and from 1970 to 1990, are compared from the standpoint of change of the disease structure, the methods of diagnosis and hemostasis. The number of hemorrhages of ulcer genesis reduced from 80 to 40.3%. Changes in the pattern of the disease is associated with improved diagnostic methods and recognition of pathological processes which were previously inaccessible to radiological examination, such as the Mallory-Weiss syndrome, acute ulcerations of the mucosa. The age composition remains relatively stable. Just like in the previous years, each third patient is over 6.0 years of age. Despite introduction of new methods of treatment, such as endoscopic arrest of bleeding, enteral feeding, a new method for management of penetrating ulcers and others, the mortality rate reduced only from 4.5% (1950-1969) to 3.4% (1970-1990). It is noted, however, that fatal outcomes in the last years prevail among patients aged 65-70 or older.