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[Acute upper gastrointestinal bleeding in Chang Gung Memorial Hospital: comparison between 1980 and 1989]
1Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Upper gastrointestinal bleeding causes shifted over a decade, with duodenal ulcers decreasing and esophageal varices increasing. This study analyzed trends in bleeding etiology between 1980 and 1989.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Epidemiology
Background:
- Upper gastrointestinal (UGI) bleeding is a significant medical issue.
- Despite advancements in diagnosis and treatment, UGI bleeding remains a challenge.
Purpose of the Study:
- To analyze the changing patterns of UGI bleeding etiology over a ten-year period.
- To compare the incidence of various causes of UGI bleeding in 1980 versus 1989.
Main Methods:
- Retrospective analysis of 560 UGI bleeding cases from 1980.
- Retrospective analysis of 1872 UGI bleeding cases from 1989.
- Comparison of etiological distribution and demographic data between the two study years.
Main Results:
- Duodenal ulcer bleeding, the primary cause, significantly decreased from 57.8% to 46.3%.
- Esophageal varices bleeding incidence significantly increased from 6.6% to 11.4%.
- Gastric ulcers remained the second most common cause, with a slight increase from 11.1% to 13.5%.
Conclusions:
- The etiology of upper gastrointestinal bleeding demonstrated significant shifts between 1980 and 1989.
- A notable decrease in duodenal ulcer bleeding and a concurrent rise in esophageal varices bleeding were observed.
- Understanding these evolving trends is crucial for managing UGI bleeding effectively.
Abstract:
Upper gastrointestinal (UGI) bleeding remains a great medical problem despite the improvement in both diagnostic and therapeutic management. We retrospectively analyzed 560 cases (male 429 cases, female 131 cases, mean age 45.8 +/- 23.1 years) of acute UGI bleeding within one year from January to December 1980, and 1872 cases (male 1395 cases, female 477 cases, mean age 48.7 +/- 27.5 years) within one year from January to December 1989, in order to define the changing pattern of etiology in the past 10 years. The major cause of bleeding was duodenal ulcer bleeding, which occurred at the age of 20-40 years. The incidence significantly decreased (57.8% in 1980 VS. 46.3% in 1989, P < 0.001). The second common cause was gastric ulcer (11.1% VS. 13.5%), which occurred mainly at the age of 50-70 years. The third was esophageal varices bleeding with a significantly increased incidence (6.6% VS. 11.4%, P < 0.001), which occurred mainly at the age of 40-60 years. The other less common causes included gastric cancer (5.9% VS. 5.8%), which occurred mainly at the age of 50-70 years, gastric erosion (5.2% VS. 6.1%), Mallory Weiss tear (2.1% VS. 3.1%), esophagitis (1.9% VS. 2.9%), Dieulafoy's ulcer (1.6% VS. 2.7%), vascular lesion (1.6% VS. 2.6%), and non-diagnostic cases (6.2% VS. 5.6%). The ratio of male to female for each etiology of UGI bleeding was about 3 to 1 in both 1980 and 1989.(ABSTRACT TRUNCATED AT 250 WORDS)