[Burns complicated by gastrointestinal haemorrhage--an analysis of 70 cases]

Burn patients complicated with hematemesis or typical melena were reviewed. Patients with only positive occult blood in the feces were not included. The incidence rate was 1.51%. This complication occurred in any age-group with similar incidence. Unstable burn shock in early stage was one of the important factors for this complication. The morbidity (16.5%) in early shock group was significantly (P less than 0.01) higher than in non-shock group (0.3%). It appeared mainly within three weeks postburn and predominantly in the first week (55.7%). Ulceration might occur in the whole gastrointestinal tract but duodenum was the most frequent site, where ulceration was recognized in 12 out 22 cases, either at postmortem or at operation. The frequency of ulceration in other portions was as follows: stomach 7, oesophagus 3, jejunum 1 and colon 1. The haemoglobin prior to or after hemorrhage had been determined in 54 cases. The decreased values varied from 1 to 10.8 g (mean 3.54 +/- 2.02 g). Of the 70 cases, 31.4% were complicated by haemorrhagic shock, and there were no distinct prodromal symptoms prior to bleeding, except in 25.5% cases there was a complaint of abdominal pain. Of the 49 deaths, 7 died of haemorrhagic shock, 4 of DIC, 1 of abdominal pain. Of the ulcer and 37 of septicemia. Our data showed that the mortality rate was rather high, especially when it coexisted with sepsis. The diagnosis and some problems about therapy are discussed in this paper.