Sa1653 Comparative Clinical Study of Patients With Upper Non-Variceal Gastrointestinal Bleeding From Peptic Ulcers and Dieulafoy Lesions

Abstract

Comparative Clinical Study of Patients With Upper Non-Variceal Gastrointestinal Bleeding From Peptic Ulcers and Dieulafoy Lesions Genaro Vazquez-Elizondo, Jose A Gonzalez, Aldo A. Garza, Hector J. Maldonado Centro Regional para el Estudio de las Enfermedades Digestivas, Hospital Universitario de Nuevo Leon, Monterrey, Mexico Background: To our knowledge, no clinical study comparing the clinical course, complications and mortality of non-variceal upper gastrointestinal bleeding form Dieulafoy lesions (DL) and peptic ulcers (PU) had been reported. Aim. To compare the demographic data, clinical evolution, complications and mortality between patients with bleeding from Dieulafoy lesions and peptic ulcer. Methods: From a previously collected database (2000 to 2009) we identified all consecutive patients admitted with diagnosis of upper gastrointestinal bleeding from DL and PU. We studied demographic data, clinical features, endoscopic findings and treatment, length of hospital stay, complications and mortality. Variables were expressed as mean and standard deviation and descriptive and comparative statistics were used for comparisons. Results: Of 1067 patients with non-variceal upper gastrointestinal bleeding, 593 patients had PU; gastric in 308 (28.9%) and duodenal in 240 (22.5%) and 22 (2.1%) patients had a DL. Table 1 shows main results; we found a significant differences on regard of age, endoscopy timing, presence of bright red blood hematemesis, rebleeding and bleeding related mortality. When analyzing dead patients in DL group (4/22 patients), 3 had in hospital bleeding, 3 rebleed, 3 died from hipovolemic shock and one for sepsis. Conclusions: Patients with DL were younger and more frequently presents with bright red blood hematemesis than PU patients. Patients with in-hospital bleeding and DL had a higher bleeding related mortality.