Current status of management of benign bleeding peptic ulcer in Al-Gamhouria Teaching Hospital, Aden, Yemen

ABSTRACT

We aimed to explore and analyze current status of bleeding peptic ulcers in surgical patients. The study was carried out at the Surgical Department of Al-Gamhouria Teaching Hospital, Aden-Yemen. It was divided into 2 parts. Group [A] patients, admitted with bleeding peptic ulcers during the period May 1998 to April 2003, were retrospectively evaluated, and the prospective group [B] that included patients admitted during the period May 2003 to April 2006. One hundred and twenty patients were enrolled in the study; 75% were in group [A] and 25% in [B]. Men were [103] and women [17], with a ratio of [6.11]. Overall mean age was 43.4 years [ranging 17 to 70 years] with 23 patients [19.17%] over 60 years. Endoscopic activity within the first 24 hours in group [A] was [55.56%] and zero in [B]. Ratio of bleeding duodenal to gastric ulcers was [21]. Bleeding was massive and /or recurred in [32.5%] of patients, with transfusion of 3-9 units of blood [mean - 5.38]. Surgery was performed only in the retrospective group - in [11.11%]. Hospital stay time was for group [A] and [B] 17.5 and 9 days respectively. Overall death rate was [8.33%]; it was less in group [A] than [B] - [6.67%] and [13.3%] respectively. In patients treated only conservatively, death rates in [A] and [B] were [7.5%] and [13.3%] respectively. Nevertheless, death rates were statistically not significant. Overall outlook was quite alarming. Lack of good administration, limited resources, and lack of necessary equipments played the major role in improper management of these patients. To improve the situation, it is recommended to prepare guidelines and establish a well equipped and well functioning endoscopy unit