Analysis of the Death due to Ulcerative Upper Gastrointestinal Hemorrhage: in autopsy cases.

Kim, Yu Hee

Original article

Korean Journal of Legal Medicine 1999;23(2):47-61.
Published online October 31, 1999.

Analysis of the Death due to Ulcerative Upper Gastrointestinal Hemorrhage: in autopsy cases.

Yu Hee Kim

National Institute of Scientific Investigation (NISI), Korea.

Abstract

Upper gastrointestinal (UGI) hemorrhage remains one of the more common cause of emergency hospital admissions. The majority of patients with ulcer bleeding will not have recurrent bleeding, but 25% of patients will have recurrent or continuous bleeding and require further therapy. Endoscopy is the preferred investigative procedure for UGI bleeding because of its accuracy and low complication rate. Although no study has clearly demonstrated improved mortality rates attributable specifically to the use of endoscopy, it is likely that improved therapeutic outcome lags behind diagnostic advances. All of these 4 patients died eventually due to the massive UGI bleeding in hospital and autopsy was done between September, 1997. and May, 1998. in National Institute of Scientific Investigation (NISI). Despite major advances in diagnostic and therapeutic capabilities, mortality from this often devastating condition remains unacceptably high. The optimal balance between operative and non-operative therapy has yet to be determined. So the close cooperation between internist and surgeon is required.

Key Words: upper gastrointestinal hemorrhage, endoscopy, mortality