Bleeding duodenal ulcer. A prospective evaluation of risk factors for rebleeding and death

F. J. Branicki, J. Boey, P. J. Fok, C. J. Pritchett, S. T. Fan, E. C.S. Sai, F. P.T. Mok, W. S. Wong, S. K. Lam, W. M. Hui, M. M.T. Ng, A. S.F. Lok, D. K.H. Lam, M. C.K. Tse, A. P.K. Tang, J. Wong

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Abstract

There were 12 hospital deaths in 433 patients (2.8%, 1.6% at 30 days) presenting with bleeding duodenal ulcer. Excluding patients who underwent immediate operation or early elective surgery, where ulcer size was measured at initial endoscopy rebleeding was evident in 40/228 patients (13.9%) and was associated with an increased mortality (0.4% v 12.5%) (p<0.0001). Rebleeding rates for ulcers ≤ 1 cm were respectively 28/239 (11.7%) and 12/49 (24.5%) (p<0.02). Rebleeding occurred in 13/186 patients (7.0%) in whom endoscopic stigmata of recent haemorrhage were absent and in 27/102 (26.5%) with such stigmata was 3/186 patients (7.0%) in whom indoscopic stigmata of recent haemorrhage were absent and in 27/102 (26.5%) with stigmata (p<0.0001). The mortality rate for patients without stigmata was 3/186 (1.6%) whilst mortality figures for patients with ulcers ≤ 1 cm and > 1 cm in size were respectively 0/77 and 3/25 (12.0%) when stigmata were identified. Ulcers > 1 cm were more frequent in the > 60 year age group, more likely to have stigmata and carried an increased risk of rebleeding and mortality

Original languageEnglish
Pages (from-to)411-418
Number of pages8
JournalAnnals of Surgery
Volume211
Issue number4
DOIs
Publication statusPublished - 1990
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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