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Marek Winiarski, Maciej Matłok, Zbigniew Biesiada, Leszek Bolt, Magdalena Woźniak and Anna Merak

Gastrointestinal Bleeding in Patients with Acute Surgical Diseases

The aim of the study was to analyse patients in whom upper gastroinentestinal bleeding appeared during hospitalization in the surgical clinic.

Material and methods. The study group consisted on 61 patients. 35 were women and 26 were men. The mean age of women was 76 and men 64.8 years. The mean age of the whole group was 72.3 years. 30 patients (49%) were hospitalized in general surgery ward, 16 (26%) in trauma unit and 15 patients (25%) in intensive care unit.

Results. The reasons of hospitalisation in general surgery ward were: acute cholecystitis, acute pancrtatitis, peritonitis, lower extremity ischemia with foot necrosis, large bowel cancer and cancer of the gall-bladder. Patients were admitted to trauma unit because of hip and pelvic fractures. Patients were hospitalized in intensive care unit because of polytrauma, diffuse peritonitis, isolated head trauma and necrotising pancreatitis. The main source of bleeding were duodenal and gastric ulcers. It appeared in 28 (45.9%) and 18 (29.5%) patients respectively. The other reasons of bleeding were: erosive gastritis (9 patients) and Mallory-Weiss syndrome (6 patients). Bleeding recurrence was found in 21 patients (34.4%). This group of patients was characterised by high mortality rate 43%. The highest was among patients in intensive care unit. It reached 60%.

Conclusions. Based on the performed analysis we come to the following conclusions: 1. Upper gastrointestinal bleeding is serious complication during hospitalisation in surgical clinic; 2. Usually it affects older patients; 3. This complication is associated with high rate of rebleeding and high mortality rate.