The management of bleeding gastric ulcer: a prospective study

In a prospective study of six years' experience with a haematemesis and melaena unit from 1972 to 1978, there were 98 admissions of patients with bleeding gastric ulcer. There were ten deaths, giving a mortality of 11%. Forty-one patients were treated by emergency surgery with seven deaths, an operative mortality of 17%. All ten deaths occurred in the first four years; there were no deaths during the final two-year period (38 admissions). In retrospective studies at Prince Henry's Hospital, Melbourne, it was found that the mortality for bleeding gastric ulcer was 17% to 18% for the period 1951 to 1970. It is concluded that a prospective system of management with an active policy of early endoscopy and surgery and regular audit of results reduces the mortality from bleeding gastric ulcer.