Is upper gastrointestinal bleeding still a life-threatening condition?

Background: Upper gastrointestinal bleeding is a common clinical problem and one of the main reasons foremergency hospitalization. It is associated with an overall mortality rate of 2% to 13%, despite advances in medicaltherapy. First-choice management is conservative treatment with endoscopic hemostasis.Aim of the study: The aim of the study was to examine the epidemiological and clinical characteristics ofpatients with upper gastrointestinal bleeding with a focus on the course of hospitalization based on the etiologyMaterial and methods: A retrospective study was conducted in the Department of Surgery at the 4th MilitaryTeaching Hospital in the years 2011–2016, comprising a total of 200 hospitalizations. 150 (75%) of the studygroup were men, and the mean age was 63.6±15.8 years.Results: Patients most frequently presented with melena (n=105; 53.1%) and hematemesis (n=79; 40%) or coffeeground vomiting (n=57; 28.7%). . 138 (69%) of hemorrhages were managed with endoscopic hemostasis, andin 43 (21.5%) of cases conservative treatment was adequate. In 12 (6%) of cases, laparotomy was the first-choicetherapy and in 7 (3.5%) cases, surgery was performed after an attempt at endoscopic treatment had failed. Thesources of bleeding were: gastric ulcer – 58 (29%), duodenal ulcer – 48 (24%), esophageal varices – 31 (15.5%),gastric tumor – 15 (7.5%), Mallory-Weiss syndrome – 10 (5%), and Dieulafoy’s lesion – 3 (1.5%). 16 (8%) of thehospitalizations were fatal.Conclusions: Upper gastrointestinal bleeding still has a high mortality rate (8%). It more frequently affects menand the elderly. Gastric and duodenal ulcers are the most common etiologies of bleeding. Esophageal varices andneoplasms are also a significant source of bleeding. Despite the progress in the pharmacological treatment of pepticulcers, the complications resulting from gastrointestinal bleeding continue to be a serious clinical problem.