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[Upper digestive tract hemorrhage; an assessment in the Amsterdam region]
E M Vreeburg1, J W de Bruijne, J W Bartelsman
1Academisch Medisch Centrum, afd. Maag-darm-leverziekten, Amsterdam.
Objective:
To inventory diagnostic and therapeutic strategies and the value of endoscopy in upper gastrointestinal haemorrhage in Amsterdam and environs.
Design:
Descriptive.
Setting:
Eight hospitals in and around Amsterdam.
Method:
For 3 months all patients with upper gastrointestinal haemorrhage were recorded. The total group consisted of 132 patients.
Results:
The group included 81 men and 51 women, the mean age was 63 years. Prior to the symptoms, 44% had used acetylsalicylic acid, non-steroidal anti-inflammatory drugs or oral anticoagulants. Diagnostic endoscopy was performed in 85% within 24 hours. The most frequent diagnosis was ulcerative disease (48%). Medication was given to 86% of the patients, 20% underwent endoscopic (injection) therapy and only 17% were operated on. Recurrent haemorrhage was seen in 24%, overall mortality was 6%.
Conclusion:
Ulcerative disease is still the most common cause of upper gastrointestinal haemorrhage. Medication is still more or less routinely administered, despite lacking proof of efficacy.