Bleeding Complications of Peptic Ulcers

Abstract

Introduction: Despite improvements in the diagnosis and treatment of peptic ulcer disease, there are still complications, including upper gastrointestinal hemorrhage, a life-threatening medical and surgical emergency. The aim of this study was to describe the epidemiological, diagnostic, therapeutic and evolving aspects of the hemorrhagic complication of peptic ulcers. Methodology : Retrospective cross-sectional study conducted over 3 years at the Kara University Hospital. All patients hospitalized for upper gastrointestinal hemorrhage of ulcer origin were included. The diagnosis was made by upper gastrointestinal endoscopy. Results : 83 cases of ulcerative hemorrhage were collected, 51 of them were men with an average age of 51 years. Farmers were the most affected patient’s category (27%). 56% used non-steroidal anti-inflammatory drugs and 27% alcohol. Hematemesis was the main sign of hemorrhage (91%). More than half of patients sought medical attention after more than 48 hours, and 59% were in a state of hemodynamic shock. About half of the patients had an antral ulcer. Ulcers were classified as Forrest III (absence of active bleeding) in ¾ of patients. Treatment was exclusively medical in all cases. Blood products were transfused in 7 patients. The average hospital stay was 9 days, with a death rate of around 15%. Conclusion : Hemorrhagic complications of peptic ulcers occur mainly in adult males. There is a delay in consultation due to patients’ ignorance of the symptoms and, above all, their attachment to traditional therapy. Treatment was exclusively medical, with a quarter of deaths. Raising public awareness, improving technical facilities and training qualified personnel would enable effective management of these ulcerative hemorrhages, thereby reducing mortality.