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Varis Dışı Üst Gastrointestinal Sistem Kanamalı 524 Olgunun Değerlendirilmesi

Evaluation of 524 Cases With Non-Variceal Gastrointestinal System Bleeding

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Abstract (2. Language): 
Background/aim: Non-variceal upper gastrointestinal system bleedings (NVUGISB) are one of the most frequent emergencies seen in the gastroenterology clinics. In the present study, we aimed to determine the etiologic and risk factors, treatment modalities and mortality rate of NVUGISB cases. Material and methods: 524 cases with NVUGISB referred to İnönü University Medical School, Gastroenterology Department between 2003-2007 years and examined with endoscopy were evaluated retrospectively in terms of demographical characteristics, etiology, risk factors, treatment modalities and mortality. Results: Mean age of 404 male (77%) and 120 female (23%), 524 cases in total was 58.4 (18-92). 217 of the cases (41%) were smoking, 36 (7%) were drinking alcohol, 143 (27%) were using acetyl salicylic acid (ASA), 21 (23%) non-steroidal anti-inflammatory drug (NSAID), 28 (5%) anticoagulant agent, 5 (1%) corticosteroid, and 269 (51%) had co-morbidity. The first three most common causes of bleeding detected by endoscopy were duodenal ulcer (245 (47%)), gastric ulcer 122 (%23) and erosive bulbitis (37 (7%)). 503 (%96) of the cases responded to medical therapy whereas 11 (2.1%) cases required surgical intervention. Only ten patients (1.9%) died. Conclusion: Duodenal ulcer is the most common cause of NVUGISB detected by endoscopy. ASA or NSAID were found as risk factors in half of the bleeding cases. Bleeding is seen in males and elders more commonly and advanced age and co-morbid diseases increase the mortality.
Abstract (Original Language): 
Giriş ve amaç: Varis dışı üst gastrointestinal sistem kanaması (VDÜGİSK), gastroenteroloji kliniklerinde sık karşılaşılan önemli acillerinden birisidir. Bu çalışmada; VDÜGİSK tanılı olgularımızın etiyolojik faktörlerinin, risk faktörlerinin, tedavilerinin ve mortalitelerinin değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: İnönü Üniversitesi Tıp Fakültesi Gastroenteroloji Kliniği’nde 2003-2007 yılları arasında VDÜGİSK nedeniyle endoskopi yapılarak izlenmiş olan 524 olgu demografik özellikleri, etiyolojileri, risk faktörleri, tedavileri ve mortaliteleri yönünden retrospektif olarak değerlendirilmiştir. Bulgular: Dört yüz dört erkek (%77), 120 kadın (%23), toplam 524 olgunun yaş ortalaması 58.4 (18-92) idi. Olguların 217’sinde (%41) sigara, 36’sınde (%7) alkol, 143’ünde (%27) aspirin 121’inde (%23) nonsteroid antiinflamatuvar ilaç (NSAİİ), 28’inde (%5) antikoagulan ilaç, 5’inde (%1) steroid kullanımı, 269’unda (% 51) yandaş hastalık saptandı. Endoskopi ile en sık saptanan ilk üç kanama nedeni; 245 (%47) olguda duodenum ülseri, 122 (%23) olguda mide ülseri, 37 (%7) olguda eroziv gastrit idi. Olguların 503’ü (%96) medikal ve endoskopik tedaviye, 11’i (%2.1) cerrahi tedaviye yanıt verdi. Toplam olarak 10 olgu (%1.9) kaybedildi. Sonuç: Endoskopik olarak, VDÜGİSK’nin en sık nedeninin duodenal ülser olduğu saptanmıştır. Kanamalı olguların yarısında Aspirin veya NSAİİ kullanımı risk faktörü olarak bulunmaktadır. Kanama erkeklerde ve yaşlılarda daha sık görülmekte, ileri yaş ve yandaş hastalıklar mortaliteyi artırmaktadır.
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