Bleeding duodenal ulcer: A prospective evaluation of risk factors for rebleeding and death

Frank J. Branicki, John Boey, Peter J. Fok, Christopher J. Pritchett, Sheung Tat Fan, Edward C.S. Lai, Francis P.T. Mok, Wai Sang Wong, S. K. Lam, Wai Mo Hui, Matthew M.T. Ng, Anna S.F. Lok, David K.H. Lam, Alan P.K. Tang, John Wong

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There were 12 hospital deaths in 433 patients (2.8%, 1.6% at 30 days) presenting with bleeding duodenal ulcer. Excluding patients who underwent immediate operation or early elective surgery, where ulcer size was measured at initial endoscopy rebleeding was evident in 40/288 patients (13.9%) and was associated with an increased mortality (0.4% v 12.5%) (p < 0.0001). Rebleeding rates for ulcers ≤ 1cm and > 1cm were respectively 28/239 (11.7%) and 12/49 (24.5%) (p < 0.02). Rebleeding occurred in 13/186 patients (7.0%) in whom endoscopic stigmata of recent haemorrhage were absent and in 27/102 (26.5%) with such stigmata (p < 0.0001). The mortality rate for patients without stigmata was 3/186 (1.6%) whilst mortality figures for patients with ulcers ≤ 1cm and > 1cm in size were respectively 0/ 77 and 3/25 (12.0%) when stigmata were identified. Ulcers > 1cm were more frequent in the > 60 year age group, more likely to have stigmata and carried an increased risk of rebleeding and mortality.

Original languageEnglish
Pages (from-to)411-418
Number of pages8
JournalAnnals of Surgery
Issue number4
Publication statusPublished - 1990
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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