Bleeding from the alimentary canal during the management of spinal cord injury patients

In the years 1970-1984, among 2000 patients with spinal cord injuries treated in our clinic, 52 had severe haemorrhage from the alimentary canal. They mainly concerned patients without a peptic ulcer history. This study gives an analysis of this group of patients with the description of the level and of the degree of spinal cord injury, the time of the onset of the haemorrhage, the pharmacological treatment applied that could influence the occurrence of bleeding and the results of the treatment. Bleeding most often occurred in patients with a complete injury of the cervical spinal cord during the early post-injury period. It is probably due to a severe disturbance of autonomic system function. It appears that the use of anticoagulants and of steroids can predispose to the occurrence of bleeding, but it is not the basic factor. Diagnostic difficulties in these patients causing a delay in the onset of proper treatment are stressed.