title: Peptic upper gastrointestinal bleeding: diagnosis and treatment. A monocentric experience on a 5 years period.
abstract: OBJECTIVE
  We evaluated all the cases of upper gastrointestinal hemorrhages admitted in the Department of Endoscopy of our Clinic during a 5 years period.
  
  
  METHODS
  810 patients were included in our study, 64.3% males and 36.7% females, mean age 58.7 +/- 15.2 years (17-96 years). The main cause of the upper digestive hemorrhage was peptic ulcer (82.6%), equally divided in gastric and duodenal. All the ulcers were assessed according to the Forrest classification.
  
  
  RESULTS
  Endoscopic haemostasis was performed in 40% of all cases, only epinephrine injection (1/10,000) in 44.4% of cases; combined therapy (injection + clip or thermocoagulation) in 40.3% of the cases and clip or thermocoagulation alone in 15.3% of the cases. A marked reduction of haemostasis using epinephrine injection alone (as monotherapy) was observed during the period of study. Postendoscopic treatment rebleeding occurred in 19.8% of cases; 3.6% of the patients have had a fatal outcome and surgical treatment was needed in 2.7% of cases.
  
  
  CONCLUSIONS
  In an experienced Department of Endoscopy, the majority of upper gastrointestinal hemorrhages can be endoscopically treated with good results. In the last years, endoscopical haemostatic bitherapy (adrenaline injection+clipping or bipolar coagulation) replaced injection of adrenaline like monotherapy for ulcer hemostasis.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timişoara, Romania. isporea@umft.ro
authors.forename: I
authors.initials: I
authors.lastname: Sporea
authors.forename: Daniela
authors.initials: D
authors.lastname: Lazăr
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.forename: A
authors.initials: A
authors.lastname: Goldiş
authors.forename: M
authors.initials: M
authors.lastname: Străin
authors.forename: Adriana
authors.initials: A
authors.lastname: Tudora
authors.forename: Mirela
authors.initials: M
authors.lastname: Dănilă
authors.forename: V
authors.initials: V
authors.lastname: Dănilă
authors.forename: Corina
authors.initials: C
authors.lastname: Vernic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D004564:Electrocoagulation; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014662:Vasoconstrictor Agents