[Risk factors in the development of bleeding peptic ulcer].
BACKGROUND
Gastric or duodenal peptic ulcer is the most common cause of bleeding from upper parts of the alimentary tract. Although there is a great number of these patients in the clinical practice, there are some contradictory characteristics in regard to the age of patient, localization of ulcer, the diameter of ulcer and Helicobacter pylori infection as possible risk factors in development of bleeding peptic ulcer. The aim of this work is evaluation of risk factors in our patients.


METHODS
During this research we examened two groups of patients: a) first group consisted of patients with acute gastric or duodenal bleeding peptic ulcer, b) the second group consisted of patients without peptic ulcer bleeding. In both groups of patients we examined the most common risk factors for development of bleeding. This research took place in the Clinic for Surgery "Dr Dragisa Misović" in the period from January to December 1997.


RESULTS
In both groups we had male predominance. Patients with bleeding peptic ulcers are statistically older when compared with the non-bleeding group (52.2 +/- 7.3:65.3 +/- 8.1). In both groups the anterior wall of the duodenum is the most common localization. In the group of bleeding ulcers we had high frequency of patients with localization of ulcers in the back wall of the duodenal bulb (20%). In this group of patients there was a high percentage of penetrating ulcers (62.5%) with active arterial bleeding (Forrest I a). Ulcers on the front wall of duodenal bulb and in small bend of stomach, as most common (over 50%), gave small peptic ulcers (under l cm) with capillary bleeding (oozing-Forrest I b) without haemodynamic complications. The presence of Helicobacter pylori infection is statistically significantly higher in the group of patients with bleeding peptic ulcers.


CONCLUSIONS
The age of patients and localization of ulcer are very important and well known risk factors for development of bleeding peptic ulcer. However, in the last ten years Helicobacter pylori infection has become one of the most important risk factors. All Helicobacter pylori positive patients were treated with three component eradicational therapy for Helicobacter pylori. In this way we restricted the number of recurrent bleeding.


CONCLUSIONS
In our opinion the age of patient, localization of ulcer, diameter and Helicobacter pylori infection are very important risk factors for development of bleeding peptic ulcer.
Stevanović
D
D
Klinicko-bolnicki centar Dr Dragisa Misović, Beograd.
Ivanisević
V
V
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology*; D012307:Risk Factors