Korean J Gastrointest Endosc > Volume 31(2); 2005 > Article
Korean Journal of Gastrointestinal Endoscopy 2005;31(2): 77-83.
화상 환자에서 발생한 상부 위장관 출혈의 임상 양상
김근숙·장현주·은창수·계세협·박우정·전 욱*·김종현*·이 진
한림대학교 의과대학 내과학교실, *외과학교실
The Clinical Features of Upper Gastrointestinal Bleeding after Acute Burn Injury
Geun Sook Kim, M.D., Hyun Joo Jang, M.D., Chang Soo Eun, M.D., Sea Hyub Kae, M.D.,Woo Jung Park, M.D., Wook Chun, M.D.*, Jong Hyun Kim, M.D.* and Jin Lee, M.D.
Departments of Internal Medicine and *Surgery, Hallym University College of Medicine, Seoul, Korea
Abstract

Background/Aims:
Upper gastrointestinal (UGI) bleeding is one of the most common and serious complications in major burns. However, the clinical features of UGI bleeding have rarely been studied, and no report of UGI bleeding after burn injury has been presented in Korea. The aim of this study was to evaluate the clinical features of the UGI bleeding after acute burn injury.
Methods:
Among 2,340 patieats with acute burn injury who have admitted from January 2000 to June 2004, 33 patients had UGI bleeding. We retrospectively reviewed the medical records of these 33 patients.
Results:
The causes of bleeding were gastric ulcer (45.5%), duodenal ulcer (36.4%), esophageal ulcer (6%), Mallory-Weiss tear (6%), hemorrhagic gastritis (3%), and gastric varix (3%). Endoscopic intervention and medical treatment were taken in 13 patients (39.4%), and 20 patients (60.6%) were managed with medical treatment only. Mortality rate of post-burn UGI bleeding patients was 30.3%. In logistic regression analysis, burn size (p=0.047) and Rockall score (p=0.019) were independent risk factors of mortality in patients with UGI bleeding.
Conclusions:
The most common cause of UGI bleeding in burn patients is peptic ulcer. Treatment of systemic complications of burn as well as UGI bleeding itself may be important in clinical course of UGI bleeding after burn. Large, randomized, and prospective study of prophylactic proton pump inhibitor for the prevention of post-burn UGI bleeding is needed. (Korean J Gastrointest Endosc 2005;31:77⁣83)
Key Words: Burn, Upper gastrointestinal bleeding
주요어: 화상, 상부 위장관 출혈
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