Etiology and course of acute bleeding esophageal ulcers

Herbert C. Wolfsen, Kenneth K. Wang

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Twenty (2%) of 1,140 patients with acute gastrointestinal bleeding had esophageal ulcers. Patients with esophageal ulcers most commonly had either melena (40%) or melena and hematemesis (40%). Fifty percent had orthostatic hypotension, and 80% required transfusions. Ulcers were associated with nonsteroidal antiinflammatory drugs (NSAIDs) use in 50%, hiatal hernia in 60%, and esophagitis in 40%. Endoscopic stigmata of recent hemorrhage consisted of cozing blood (35%) and adherent clot (25%), Six patients had multiple ulcers. The majority of ulcers (90%) were in the distal esophagus. Nine patients were endoscopically treated without complications except for rebleeding in 1 patient. Endoscopic therapy was associated with decreased duration of hospitalization. Overall mortality was 45% in these patients, but no deaths were related to bleeding. Although uncommon, esophageal ulcers are a cause of significant acute gastrointestinal bleeding that appears to respond to endoscopic treatment.

Original languageEnglish (US)
Pages (from-to)342-346
Number of pages5
JournalJournal of clinical gastroenterology
Volume14
Issue number4
DOIs
StatePublished - Jun 1992

Keywords

  • Barrett esophagus
  • Esophagus
  • Gastrointestinal endoscopy
  • Gastrointestinal hemorrhage
  • Hiatal hernia
  • Nonsteroidal antiinflammatory agents
  • Ulcer

ASJC Scopus subject areas

  • Gastroenterology

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