Natural history of bleeding peptic ulcers with a tightly adherent blood clot: a prospective observation

Hwai Jeng Lin, Kun Wang, Chin Lin Perng, Fa Yauh Lee, Chen Hsen Lee, Shou Dong Lee

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51 Citations (Scopus)

Abstract

Background: The natural history of a bleeding peptic ulcer with a tightly adherent blood clot remains uncertain. Controversy exists concerning removal of such blood clots at the bleeding ulcer base. This article presents the natural history of a bleeding peptic ulcer with a tightly adherent clot and defines the characteristics of those requiring aggressive management. Methods: Clinical parameters were analyzed to determine the independent predictors of rebleeding in these patients. One hundred one patients with bleeding peptic ulcers and tightly adherent blood clots were enrolled during a period of 12 months. Results: Twenty-five patients (25%) rebled within 1 month. With a multivariate analysis, we found comorbid illness (odds ratio, 3.41), shock (odds ratio, 3.65), and intial hemoglobin at or below 10 gm/dL (odds ratio, 2.99) to be independent predictors of rebleeding. Conclusions: Most patients with a tightly adherent clot in an ulcer have an uneventful course. However, endoscopic therapy may prove to be beneficial in the subset of patients with independent predictors of rebleeding.

Original languageEnglish
Pages (from-to)470-473
Number of pages4
JournalGastrointestinal Endoscopy
Volume43
Issue number2 PART 2
Publication statusPublished - 1996
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology

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