Related Experiment Videos
[Severe hemorrhage from gastroduodenal ulcer. Apropos of 100 cases]
J C Le Neel1, B Guiberteau, O Armstrong
1Clinique Chirurgicale A, Hôtel-Dieu, Nantes.
Insights
This study analyzed 100 patients with ulcer-related digestive tract hemorrhage over seven years. Conservative treatment was effective in most cases, but surgical intervention was necessary for severe or persistent bleeding, with a notable mortality rate.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Context:
- Digestive tract hemorrhage is a significant clinical challenge.
- Peptic ulcers are a common cause of gastrointestinal bleeding.
- Management of severe or recurrent bleeding requires careful consideration.
Purpose:
- To analyze surgical outcomes for patients with ulcer-induced digestive tract hemorrhage.
- To evaluate factors influencing the need for surgery versus conservative management.
- To assess complications and mortality associated with surgical intervention.
Summary:
- A 7-year study involved 100 patients (mean age 66) operated for ulcer-related digestive tract hemorrhage.
- Indications for surgery included massive, persistent, recurrent bleeding, or visible vessels; conservative treatment was feasible in 75% of cases.
- Gastrectomy was performed in 26 patients, with 55 uneventful follow-ups, 18 complications, and 27 deaths.
Impact:
- Provides insights into the surgical management of a common gastrointestinal emergency.
- Highlights the importance of patient history and endoscopic findings in treatment decisions.
- Contributes data on surgical outcomes, complications, and mortality for ulcer bleeding.
Abstract:
Over a period of 7 years, 100 patients (70 males and 30 females; mean age 66 years) were operated for digestive tract haemorrhage originating in an ulcer. There was a past history of ulcer in 21% and 29% had been taking drugs known to have a toxic effect on the stomach. Patent bleeding was observed by endoscopy in 32% with clear arterial flow, or a visible vessel in 10. In 20 patients a fresh clot was observed. Surgery had been indicated for massive haemorrhage in 25 cases, for persistent bleeding in 27, for recurrent bleeding in 37 and due to a visible vessel in 11. Conservative treatment was possible in three-fourths of the cases. Gastrectomy was performed in 26. Follow-up was uneventful in 55. There were 18 cases with complications and 27 deaths factors leading to fatal outcome and the data reported in the literature were analyzed.