Upper gastrintestinal bleeding after a decade: The effect of newly introduced endoscopic haemostatic procedures

Introduction: Using a retrospective analysis the cases of upper gastrointestinal bleeding, changing in the rate of bleeding sources were investigated by the authors in the years 1995 and 2005. There was also analyzed the influence of newly introduced endoscopic haemostatic procedures on the number of surgical interventions, amount of transfusion and mortality.

Discussion: In 1995 in 134 patients (female/male ratio: 42/82), while in 2005 in 195 (female/male ratio: 66/119) was performed urgent upper gastrointestinal endoscopy. There was no significant change in the number of bleeding esophageal varices (25/23). Increase in frequency of bleeding from gastric ulcer by 42% (34/58), duodenal ulcer by 15% (35/41), Mallory-Weis syndrome by 32% (11/16), gastric erosions by 53% (15/32), duodenal erosions by 58% (8/19) was observed. In 1995 for bleeding esophageal varices endoscopic sclerotherapy was performed exclusively (24 cases). Of the meanwhile introduced procedures the injection therapy (58), HPU coagulation (34), injection +HPU therapy (33), metal clip application (5), argonplasma therapy (6), urgent varix ligation (3) were used. In 1995 the 69% (94) of patients got transfusions (altogether: 292 U, average: 3.1 U/patient), in 2005 60% (117) of the individuals were transfused (altogether: 358 U, average: 3 U). In 1995 16% (22), in 2005 6,6% (13) of bleeding patients needed some kind of surgical intervention. There was no significant difference in the mortality rate during the two investigated periods.(8/7).

Conclusion: In the recent ten-year period the number of upper gastrointestinal bleeding cases has increased significantly. The need for transfusions and the number of operations have decreased. The rate of mortality did not change significantly.