부산대학교 도서관

From August, 1975 to September, 1981, endoscopic examination was performed in 238 cases of upper gastrointestinal bleeding at Fujigaoka Hospital, Showa University. Among these, 117 urgent endoscopies were examined within 48 hours after the onset of hematemesis and melena. The sources of upper gastrointestinal bleeding in 238 patients were as follows ; gastric ulcer (64), duodenal ulcer (58), gastric and duodenal ulcer (5), acute gastric mucosal lesion (18), esophageal varices (14), advanced gastric cancer (12), Mallory-Weiss syndrome (10), others (44) and unknown cases (13) . Hemostasis was a success in 29 of 30 bleeding cases treated by conservative therapy, with the exception being a case of rupture of aortic aneurysm perforated to the esophagus. The endoscopic procedure was performed on 14 bleeding lesions, including gastric and duodenal ulcers, gastric cancer and Mallory-W eiss syndrome, by means of electro-coagulation or clipping, and was successful in 9 cases. Urgent operation was performed in 10 cases of which hemorrhage continued in spite of conservative and endoscopic treatment. All cases of active variceal bleeding were treated with Sengstaken-Blakemore tube, these were thereafter treated by means of paravasal or intravasal sclerotherapy, endoscopically. Upper gastrointestinal panendoscopy was useful, not onlyin diagnosis of bleeding source, but also in treatment of patients with upper gastrointestinal hemorrhage.