Clinical observations on massive upper gastrointestinal hemorrhage in Korean
Homorrhage from the upper gastrointestinal tract in serious and never should be considered lightly. and the hemorrhage has been a source of controversial discussion for many years. There are many reports and clinical reviews on upper gastrointestinal hemorrhage in foreign countries but few from Korean.
Therefore, it may be of some value to compare a clinical picture of upper gastrointestinal hemorrhage in Koreans with that from other countries.
The author collected 248 cases of upper gastrointestinal hemorrhages which were admitted and teated at Yonsei University Medical Center over the last 5 years and 9 months from Jan. 1960 to Sept. 1965.
The incidence of upper gastrointestinal bleeding was 0.95 % of the total admissions during the aforementioned period, and was most commonly found in the 4th decade with an exceedingly high incidence in males (4:1).
The most common cause of bleeding was gastric ulcer which accounted for 65 cases out of the 248 cases of upper gastrointestinal bleeding. Other causes of bleeding were due to gastric cancer in 51 cases, esophageal varices in 36 cases, duodenal ulcer in 36 cases, gastritis in 13 cases, hiatus hernia in 1 cases, miscellaneous in 40 cases and undetermined causes in 6 cases.
In reviewing the anatomical sites of the bleeding, 52 % of the bleeding was frem the stomach, 20.9 % from the esophagus, 14.5 % from the duodenum and bleeding from an undetermined site in 8.4 % out of the total of 248 bleeding cases.
Hematemesis was the initial symptom in 156 cases among the 248 patients and 88.9% of the patients with esophageal varices showed hematemesis, 67 % of the gastriculcer cases, 58 % of those with duodenal ulcer and 50 % of those with gastric cancer showed hematemesis.
The hemoglobin value on admission showed less than 10 gm% in 53 % (132 cases) of the 248 cases and the majority of the cases received transfusions of 2 to 3 pints of whole blood.
In the management of the bleeding, 179 cases (72%) were treated medically, and 69 cases (29%) surgically.
The over-all mortality rate was 6.04 %.