상부위장관출혈의 내시경학적 진단

An;ong 1,526 cases performed gastrofiberscopy, 141 patients of upper gastrointestinal bleeding ivho v;ere admitted to the Department of Internal Me2icine, St. Marys Hospital of Catholic Kfedical College during the past 2 ye.! S and 6 months from March l, 1974 to September 6,. 1976 ivere clinically observed. The resu!ts ivere asfolloivs: 1. The incidence of upper gastrointestinal bleeding among 1,526 cases performed gastrofiber.::- copy was 9. 2%. The sex distribution was 114 in male and 27 in female with a mean age of 4b. The ratio of male to female was 4. 2: 1. 2. The sources of bleeding v;ere gastric ulcer (27. 7%), duodenal ulcer (17. 7Fo), gastric carcnoima (17% J rupture of esophageal varices (13.5%), erosive gastritis (12. 1%), gastroduc- denitis (3. 5%), misce! Janeous (5. 7%), and unknown origin (2. 1%) in order. 3. The endoscopic accuracy in patients with upper gastrointestinal bleeding was gastric ulcer CG9. 2%3, gastric carcinoma (96. Ofo), erosive gastritis (88. 2%3, and duodenal ulcer, gastroauo- denitis, and rupture of esophageal varices were 100%. 4. The success rates in identifving the site of bleeding in relation to time of endoscopy after upper gastrointestinal bleeding were 63. 2,o ivithin 24 hou."s, 47. 1% in 24 48 hours, 17. 6% in 48 72 hours, and 6. 3;o after 7 days. The success rate fell with increasing time after upper gastrointestinal bleeding. 5. The presence of more than one source of upper gastrointestinal bleeding site was found much in cur patients. The early endoscopy was more reliable than radiology for determining the origin of upper gastrointestinal bleeding, and multiple lesions were found only by endoscopic examination. 6. Complication of endoscopy for the diagnosis of upper gastrointestinal bleeding was 2 out of 141 cases (l. 4Fo): one was arterial bleeding from the lesion of gastric biopsy and the other was aggravation of gastric ulcer bleeding. Both of these was reversible.