[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
March 1985

Changing Patterns of Gastrointestinal Bleeding

Author Affiliations

From the Departments of Surgery, Veterans Administration Medical Center and the University of California, San Diego.

Arch Surg. 1985;120(3):341-344. doi:10.1001/archsurg.1985.01390270079013

• This study, a retrospective analysis of 351 patients with acute gastrointestinal (GI) hemorrhage, was undertaken to define patterns of disease and age-related operative and mortality rates and to determine changes over time related to changes in management. One third (116 patients) of the admissions had bleeding esophageal varices. Upper GI hemorrhage accounted for 85% (N=200) and lower GI hemorrhage for 15% (N=35). Emergency surgical intervention was required in 90 patients (38%), 40% of the upper and 29% of the lower GI hemorrhage patients. Benign ulcer disease accounted for 86% of the cases requiring emergency surgery and was treated with vagotomy and drainage and/or oversewing. Lower GI bleeding is seen in older patients; it has a lower operative intervention rate and a higher mortality. Stress bleeding as a surgical lesion has disappeared since 1979. A more assertive policy for surgical intervention has decreased operative mortality for all age groups. Bleeding duodenal ulcers are decreasing in incidence while gastric lesions appear to be increasing. These population-specific patterns, different from earlier periods, may have implications for training and patient management decisions.

(Arch Surg 1985;120:341-344)