BLEEDING PEPTIC ULCER: FACTORS OF LONG-TERM RECURRENCE

Aims The aim of our study is to identify the predictive factors associated with recurrent bleeding in peptic ulcers.

Methods A retrospective study including patients admitted to the emergency department with an upper GI bleeding, between January 2019 and October 2021, due to PUD.

Results PUD was diagnosed in 151 patients, 50.3% of patients admitted to the emergency department for an upper GI bleeding. Long-term recurrence was noted in 17 patients (11.2%). The mean age of the patients with recurrence was 55 years with a male predominance, sex ratio M/F: 4.6. 17.6% of the patients were taking anti-platelet agents, a history of ulcer was found in 23.5% of the cases, active smoking (35.3%) and NSAIDs (17.6%). 58.8% of the patients had been transfused in the previous bleeding episode. The ulcer was bulbar in 82.3% (35.2% on the posterior surface). The mean size of the ulcers was 14 mm. Forrest stages I and IIb were found in 41.1% of cases. Helicobacter Pylori was present in 58.8% of the cases which was not eradicated in 29.4% of patient (non-adhesion to treatment or therapeutic resistance) and non-adherence to PPI was observed in 23.5% of the cases.

Conclusions The prevention of recurrent bleeding in PUD should not stop only at the treatment of the acute phase, but also at the monitoring and control of certain predictive factors of recurrence. In our study, the recurrence was mainly in bulbar ulcers, the main parameters involved being: active smoking, taking NSAIDs or antiplatelet agents, non-eradication of HP and non-adhesion to treatment.

Publication History

Article published online:
14 April 2022