[Severe upper gastrointestinal hemorrhages due to peptic ulcer. A plea for admission to a surgical unit].
Despite improvements in exploratory methods and the introduction of endoscopic haemostasis procedures, bleeding remains a severe complication of peptic ulcers. A retrospective study of 142 cases collected over a 10-year period showed an overall mortality rate of 12.76 percent: 9.2 percent in non surgical patients and 17.1 percent in patients operated upon. The latter figure fell to 9 percent when cirrhotic patients were excluded. The criteria required for surgical treatment and the choice of the most appropriate operative technique are defined. In elderly people and/or in patients with underlying diseases, when the blood pressure is kept stable the risk of surgery is lower than the risk of cardiovascular collapse. This type of surgery is justified only if it eliminates all risk of recurrent bleeding.
Boutelier
P
P
Service de Chirurgie, Hôpital Jean-Verdier, Bondy.
Bertrand
P
P
Blaise
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D013276:Stomach Ulcer / Q000150:complications*
Hémorragies ulcéreuses gastro-duodénales graves. Plaidoyer pour une hospitalisation en milieu chirurgical.