[The influence of risk factors in recurrent peptic ulcer haemorrhage].

Gastrointestinal hemorrhage is one of the most frequent complications that occurs in 15 20% patients with peptic ulcer disease. Recurrent ulcer haemorrhage presents in the first 72 hours after initial bleeding: they are the most im portant cause of death. The aim of our study was to show the possibility of ulcer recurrent haemorrhage combined with risk factors: age 60, high risk lesion (active arterial bleeding, visible blood vessel, adherent coagulum), the size, ulcer base and localization (posterior duodenal wall. lesser curvature or high gastric ulcer), commorbidities ( cardiovascular and liver diseases) and haemodynamic instabilities. The combination of these risk-factor, unproportionally increases the risk: presence of two risk factors gives the possibility of recurrent bleeding of 16.67%, three risk factors 58.82%, four 93.33%, while the presence of five risk factors shows 100% posibility. Probability of death is 8.27 times greater if ulcer haemorrhage occurs.

[Surgical perspectives in treatment of bleeding peptic ulcers].

Peptic ulcer bleeding has overall incidence of 50 to 150 on 100.000 grown-ups per year and represents cause for over 1% of all urgent hospitalization today. Despite of the evolution of the endoscopic diagnostics and haemostasis, improved intensive care and surgical treatment, overall mortality is still over 10% (operative treatment over 20%), and it almost hasn't changed over past 40 years. For more than 100 years surgery had major role in treatment of peptic bleeding ulcers, whereas nowadays it is limited to treatment of its complications. Adequate surgical treatment demands properly timed operation, safest but appropriate operation and trained surgeon. Early surgery is much better compared to the last minute surgery. At high risk rebleeding ulcer, early delayed surgery appears to be adequate, since the complications and lethal outcome are more frequent in this group.