LONG TERM COURSE OF BLEEDING GASTRIC ULCER

Abstract

Two hundred and forty-four patients with bleeding gastric ulcer were encountered at emergency endoscopy during the period from February 1975 to August 1981. Emergent surgical operation was necessitated in 44 patients and 3 of them died after surgery. The other 15 of 244 patients underwent elective operation. The remaining 185 patients were treated by medical measures alone which resulted in death in 3. Thus, 182 patients were followed up endoscopically under medical treatment. Within 3 months, the healing rate in these patients reached 74.2%, which approximated that of non-bleeding gastric ulcers reported by others. Of the 128 patients followed up for 1 to 6 years, 49 recurrences were observed in 37 patients and 19 of them had 26 episodes of rebleeding. Incidence of ulcer recurrence associated with bleeding was significantly higher in patients of 60 years of age or over than those under 60 years. Cummulative rates of recurrence and bleeding were getting higher as the follow up period became longer. Out of 19 patients with rebleeding, 3 were subjected to emergency operation and 2 underwent elective operation. Bleeding gastric ulcers, especially in the aged, require careful observation not only for ulcer recurrence but for rebleeding.