A Clinical Evaluation of Upper Gastrointestinal Bleeding

A clinical observation was made on 221 cases of upper gastrointestinal bleeding, who were admitted to Ewha Womans University hospital from January, 1973 to December 1977. Following results were obtained. 1) The ratio of the number of the upper gastrointestinal bleeding to the total number of patients admitted to the department of internal medicine during the same period was 3.97% as a whole and the yearly ratio has increased since 1975. 2) of 221 cases of upper gastrointestinal bleeding, peptic ulcer was presented in 46.6%, gastric cancer in 29.0%, esophageal varices in 11.3%, gastritis in 10.0% and unknown origin in 3.2%. 3) The ratio between male and female was 2.2:1 in the total group and peak age incidence was in the sixth decade. 4) Hematemesis only was noted in 20.4% and melena only in 50.2% while hematemesis and melena were seen in 29.4%. 5) Among 221 cases, 45.7% was belonged to massive bleeding group by Hamilton's criteria. 6) The frequency of bleeding was observed that first bleeding accounted for 73.8%, second bleeding for 18.6% and bleeding more than three times for 7.7%. 7) Eighty percents of patinets were improved with conservative treatment, whereas 19.9% of patients required surgical treatment, 82.5% of the operated cases were improved. 8) The mortality rate during the hospitalization was in 5.4% and the causes were mainly due to uncontrollable bleeding, hepatic failure and renal shutdown related to sustained shock in this order.