Clinical Characteristics of Nonvariceal Vascular Upper Gastrointestinal Bleeding: Analysis of 111 Cases
10.3969/j.issn.1008-7125.2017.07.006
- VernacularTitle:111例血管相关性非静脉曲张性上消化道出血临床分析
- Author:
Xiaojuan SHAO
;
Dongfeng CHEN
- Keywords:
Nonvariceal Vascular Upper Gastrointestinal Bleeding;
Peptic Ulcer;
Vascular Malformations;
Endoscopic Therapy;
Retrospective Studies
- From:
Chinese Journal of Gastroenterology
2017;22(7):411-414
- CountryChina
- Language:Chinese
-
Abstract:
Background:Nonvariceal vascular upper gastrointestinal bleeding is a special type of nonvariceal upper gastrointestinal bleeding (NVUGIB) with serious disease course and high mortality rate, which should be paid more attention by clinicians.Aims:To explore the etiological factors and therapeutic strategies of vascular NVUGIB for improving the diagnosis and treatment of the disease.Methods:Clinical data of 111 cases of vascular NVUGIB admitted from Jan.2012 to Dec.2016 at Daping Hospital, the Third Military Medical University were retrospectively analyzed.All cases were diagnosed by gastroscopy, abdominal CT or angiography.Results:One hundred and five patients underwent a gastroscopy within 24 hours of hospital admission.The major causes of bleeding were peptic ulcer involving blood vessels (62.2%) and vascular malformation (22.5%);other causes included Dieulafoy disease, gastrointestinal stromal tumor, malignant tumor, intra-abdominal infection, trauma and gastric angiotelectasis.Seventy-eight patients (70.3%) received endoscopic hemostasis, 19 received conservative medical therapy only, 13 were treated by interventional embolization and 5 underwent surgical operation.Hemostasis was achieved in 96.4% of the patients (107 cases);in four deceased, 3 were failures of endoscopic and interventional therapies.Conclusions:Peptic ulcer and vascular malformation are the major causes of vascular NVUGIB.Endoscopic therapy has generally been recommended as the first-line treatment, however, interventional embolization or surgical operation should be used directly if necessary.