title: [Post operative upper gastrointestinal bleeding in the aged].
abstract: A 10-year experience with 2,441 patients over 65 years of age undergoing operations for non-upper gastrointestinal tracts was reviewed to evaluate both the incidence of postoperative upper gastrointestinal bleeding and the clinical risk factors associated with the complication. A total of 18 (0.7%, 7 males and 11 females) patients had overt postoperative upper gastrointestinal bleeding of non-variceal origin documented by endoscopic findings or blood transfusions. Of these, the complication developed in 10 (1.5%) of 646 patients after an operation for biliary or pancreatic disease, 1 (1.5%) of 64 for aneurysmal or obstructive arterial disease, 5 (1.1%) of 43 for colorectal cancer and 2 (0.3%) of 916 for hernia. The incidences of bleeding after an operation for obstructive jaundice (3.8%), for biliary or pancreatic malignancy (4.5%), and of unavoidable diversion colostomy for colorectal anastomosis (3.1%) were significantly higher than for non-jaundice (0.6%), for non-malignancy (1.1%) and of postoperative upper gastrointestinal bleeding in the present study. The origins of bleeding were gastric ulcer in 11, acute gastric mucosal lesion in 4, duodenal ulcer in 1 and other in 2. All cases of bleeding were treated and met success in hemostasis using H2-blockers. Of these, however, 5 patients died of multiple organ failure despite discontinued hemorrhage, prophylactic use of H2-blockers showed a decrease in occurrence of postoperative upper gastrointestinal bleeding in the present study.
authors: Department Surgery, Tokyo Metropolitan Geriatric Hospital, Japan.
authors: M
authors: M
authors: Yoshida
authors: T
authors: T
authors: Takahashi
authors: H
authors: H
authors: Hashimoto
authors: T
authors: T
authors: Noro
authors: Y
authors: Y
authors: Hino
authors: T
authors: T
authors: Hirashima
authors: H
authors: H
authors: Terashima
authors: H
authors: H
authors: Tsubuku
authors: N
authors: N
authors: Wakakuri
authors: M
authors: M
authors: Yamashiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D013276:Stomach Ulcer / Q000601:surgery