The significance of corpus anterior wall ulcers on morbidity and mortality of patients with upper gastrointestinal bleeding.

Background/aims: Acute upper gastrointestinal bleeding is a common and potentially life-threatening medical emergency. Various factors modulating morbidity and mortality on upper gastrointestinal bleeding have been reported. However, there are no reports on the prognosis of bleeding ulcers on the anterior wall of corpus (on fundus-corpus junction, 10-15 mm from the lesser curvature) bleeding ulcers on the anterior wall of the corpus. Thus, in this trial we tried to investigate the role of bleeding ulcers on the anterior wall of the corpus on acute upper gastrointestinal bleeding mortality and morbidity.

Methods: One hundred seventy-seven (63 women and 114 men, mean age 52 years) patients with a clinical diagnosis of upper gastrointestinal bleeding were endoscoped between August 1999 and December 2002. All patients were treated endoscopically, medically or with surgery. The site of the bleeding was noted and compared regarding rebleeding and mortality rates.

Results: 50% (3/6) of the patients with bleeding ulcers on the anterior wall of the corpus required further surgical procedure or were associated with mortality, but only 7% (12/171) of the patients with bleeding sites other than bleeding ulcers on the anterior wall of the corpus had mortality or required further surgical intervention (p<0.05). Recurrent bleeding occurred in 50% (3/6) of our patients with bleeding ulcers on the anterior wall of the corpus during their hospitalization compared to 7.60% (13/171) (p<0.05) of patients with bleeding sites other than bleeding ulcers on the anterior wall of the corpus.

Conclusions: Bleeding ulcers on the anterior wall of the corpus is indicative of recurrence or persistence of the hemorrhage and of greater mortality. Bleeding from this site needs more aggressive and diligent care.