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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Giant Peptic Ulcer Hemorrhages: Epidemiology, Treatment, and Outcome in the Teaching Hospital of Tartu

Department of Surgery, Tartu University, L. Puusepa 8, 51014 Tartu, Estonia
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Medicina 2011, 47(1), 3; https://doi.org/10.3390/medicina47010003
Received: 5 May 2010 / Accepted: 6 January 2011 / Published: 11 January 2011
The aim of the study was to analyze the management and outcome in the case of giant peptic ulcer hemorrhage (GPUH).
Material and Methods. We analyzed the data of all 372 cases of 348 patients treated for acute peptic ulcer hemorrhage during 2005–2007. The source and intensity of hemorrhage was assessed endoscopically according to the Forrest classifi cation: class I+II, persistent hemorrhage or signs of recent hemorrhage; and class III, ulcer without signs of recent hemorrhage. Of the 372 cases, 64 (17%) were GPUH (diameter, ≥2 cm) (group 1) and the remaining 308 (83%) were peptic ulcer hemorrhages of a standard size (SPUH) (diameter, <2 cm), which formed the control group (group 2).
Results. Forrest class I+II hemorrhage occurred significantly more frequently in the group 1 as compared with the group 2 (97% [62/64] vs. 77% [238/308]), as well as endoscopic hemostasis, (80% [51/64] vs. 57% [175/308]), repeat hemostasis procedures (22% [11/51] vs 6.3% [11/175]), and operative treatment (27.6% [16/58] vs 1.7% [5/290]) were needed more frequently in the group 1. No postoperative in-hospital deaths occurred in either group. Five patients died: 2 (3.4% [2/58]) in the group 1 and 3 (1.0% [3/290]) in the group 2.
Conclusions. GPUHs were more intensive as compared with SPUHs and needed more endoscopic hemostasis, including repeat procedures and operative treatment. Endoscopic hemostasis and operative treatment allowed reducing mortality due to GPUH to 3.4%.
Keywords: giant peptic ulcer; hemorrhage; epidemiology; treatment; outcome giant peptic ulcer; hemorrhage; epidemiology; treatment; outcome
MDPI and ACS Style

Peetsalu, A.; Kirsimägi, Ü.; Peetsalu, M. Giant Peptic Ulcer Hemorrhages: Epidemiology, Treatment, and Outcome in the Teaching Hospital of Tartu. Medicina 2011, 47, 3.

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