The Enigma of Upper Gastrointestinal Hemorrhage.

Four hundred patients with upper gastrointestinal bleeding were studied retrospectively. The source of bleeding in 47 per cent of these patients appeared to be duodenal ulcers, in 14 per cent gastric ulcers, and in 7 per cent miscellaneous etiology; the remaining 32 per cent were unknown. A history of previous upper gastrointestinal bleeding was found in one-third of all patients, but in hemorrhagic gastritis over two-thirds had bled previously. Mortality in patients with previous upper gastrointestinal bleeding was only 5 per cent as opposed to 10. per cent in the patients who had never bled before. Fifty per cent of all patients who died, entered the hospital stable and in no acute distress. In 60 per cent of the patients who expired, no diagnosis could be made, while diagnosis of duodenal ulcer was made in only 12 per cent and of gastric ulcer in 18 per cent. Of patients with previous history of duodenal ulcer no ulcer could be demonstrated in 41 per cent. [ABSTRACT FROM AUTHOR]