출혈성 위궤양의 임상적 고찰

Abstract

Management of bleeding gastric ulcer continues to present a challenge despite of improved di- agnosis and treatment. Nowadays, endoscopic intervention could control the bleeding and emergency operation would be avoid. But mortality was not decreased and the need to rnake therapeutic paradigm was increased. So we analysed 280 patients who were admitted with bleeding gastric ulcer from 1984 to 1993 at Yong dong Severance Hospital. Most frequent presentations at admission were hematemesis and melena. 31 Patients were shock and 48 patients showed severe anemia(less than 7 gm% of hemoglobin) at presentation. The average amount of transfusion was 6.1 pints. At endoscopy, arterial spurting was found at 19 patients and 60 patients showed stigmata. 204 patients received conservative management with 3.4% rnortality and 38 patients was performed endoscopic intervention with 10.7% mortality. 48 patients received surgical treatment and four were dead. Among them, there was no death in patiets who was performed surgical treatment after endoscopic intervention. The overall mortality was 5%. As a result, endoscopic intervention, if possible, could lessen blood loss and selected patients should receive surgical treatment even after cessation of bleeding.