Gender-Age and Clinicomorphological Dependencies in Patients with Gastroduodenal Bleeding of Ulcerative Origin

Abstract

Background. Despite of the revision of the pathogenetic mechanisms of appearance of gastroduodenal ulcers during the last decades, optimization of the approaches to the conservative treatment of them, development of the modern pharmacy industry, peptic ulcer of stomach and duodenum continues to be an actual problem of the modern gastroenterology. Aim. The aim of this work was to analyze group of patients with gastroduodenal bleeding of ulcerative origin in order to reveal dependencies of this condition on gender, age, clinicalomorphological features. Materials and Methods. The 204 patients with gastroduodenal bleeding of ulcerative origin were enrolled into study. There were 136 (66.7 %) men and 68 (33.3 %) women among them. The average age of the group was 56.6 ± 17.0 years. Results and Discussion. Average age among the men was lower than among the women. The most of the ulcer defects were located in duodenum. The incidence of the ulcer was higher among the men than the same value was among the women. The incidence of coronary artery disease was higher among the group of patients enrolled into study than in general population. There is the reliable dependence between the severity of bleeding (according to the Forrest) and the time of performing of initial upper gastrointestinal endoscopy. We believe that this dependence is connected with the time of the treatment beginning. The couple of factors were chosen for estimation of the risk factors of bleeding. They are gender, localization and size of ulcerative defect, activity of the bleeding according to Forrest. The gender and localization of the ulcer were proven as risk factors only. Conclusions. Coronary artery disease which is treated by acetylsalicylic acid is a risk factor of gastroduodenal bleeding of ulcerative origin. The quantity of the bleedings Forrest II becomes larger and the quantity of the bleedings Forrest I becomes smaller as duration from admission to hospital to performing of the initial endoscopic examination becomes longer. The severity of the blood loss led to increasing of the mortality among the enrolled patients. The severe and very severe blood loss are occurred reliably more often among women than among men. The incidence of severe and very severe blood loss was also higher in case of duodenal ulcer than in case of gastric ulcer.