Lege Artis Medicinae

[Prediction of rebleeding and its importance in the treatment of upper gastrointestinal bleedings originating from peptic ulcers]

ONDREJKA Pál

JULY 20, 2002

Lege Artis Medicinae - 2002;12(06-07)

[Nearly 50% of upper gastrointestinal bleedings originate from peptic ulcers. While the number of scheduled operations carried out due to peptic ulcers is decreased to nearly zero in the past decade, the number operations due to the complications of peptic ulcers remained unchanged. Bleeding from peptic ulcers usually stops spontaneously in a remarkable part of the cases, but in many times rebleeding is anticipated. These patients present several problems which are difficult to treat, and patients in need of emergency surgery are usually from this group. This is the main reason why the identification of those patients with high risk for rebleeding is important. With the help of the modified "Baylor Bleeding Score" rebleeding can be predicted. In the case of high risk for rebleeding, an early elective operation can avoid a latter urgent operation, which has markedly higher mortality and morbidity. In peptic ulcer bleeding, endoscopic treatment modalities have the priority. Most preferred method is the injection of different haemostatic drugs, with thermal methods and haemoclips being also accepted. Among surgical treatments, ”aggressive” resection operations are preferable. Additional "conservative" medical treatment with proton pump inhibitors is also recommended.]

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