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Upper gastrointestinal hemorrhage in Jordan: An analysis of causes, characteristics and outcome

A U Toukan1

  • 1Faculty of Medicine, University of Jordan, Gastrointestinal and Liver Unit, Department of Medicine, Jordan University Hospital, Amma, Jordan.

Annals of Saudi Medicine
|September 1, 1991
PubMed

Insights

Massive upper gastrointestinal hemorrhage is most commonly caused by duodenal ulcers. Age, liver disease, and transfusion needs predict mortality in these patients.

Area of Science:

  • Gastroenterology
  • Internal Medicine

Background:

  • Massive upper gastrointestinal hemorrhage is a significant clinical challenge.
  • Identifying the bleeding source is crucial for effective management.
  • Understanding patient demographics and risk factors can improve outcomes.

Purpose of the Study:

  • To determine the most common source of massive upper gastrointestinal hemorrhage.
  • To evaluate outcomes in relation to presenting variables.
  • To identify predictors of mortality.

Main Methods:

  • Prospective endoscopic evaluation of 224 patients with massive upper gastrointestinal hemorrhage within 24 hours.
  • Analysis of presenting variables, including patient demographics, medical history, and medication use.
  • Multivariate regression analysis to identify independent predictors of mortality.

Main Results:

  • Duodenal ulcer was the most frequent bleeding source.
  • 33% of patients had multiple potential bleeding sites.
  • Younger patients were more likely to have duodenal ulcers than gastric ulcers.
  • Dyspepsia was common in patients with ulcers.
  • Nonsteroidal anti-inflammatory drug (NSAID) ingestion was associated with bleeding.
  • Spontaneous resolution occurred in 69% of cases; 25% required surgery.
  • Overall mortality was 10%.

Conclusions:

  • Duodenal ulcers are the leading cause of massive upper gastrointestinal hemorrhage.
  • Age, chronic liver disease, and transfusion requirements are independent predictors of mortality.
  • Early endoscopic intervention and risk factor assessment are vital for managing these patients.

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