SEVERE UPPER GASTROINTESTINAL TUMOR BLEEDING - ENDOSCOPIC FINDINGS, TREATMENT, AND OUTCOME

Background and Study Aims: The aim of the present study was to review endoscopic findings, treatment, and clinical outcomes in patients with severe upper gastrointestinal bleeding due to tumors, Patients and Me thods: A retrospective analysis was made of prospectively gathered dat a on all patients with severe upper gastrointestinal bleeding who were admitted to two large referral centers during a 45-month period, Resu lts: Nine hundred thirty-five patients had severe upper gastrointestin al bleeding, of whom 42 (5%) were found to have tumors, Histologically , nearly all of the tumors were of a malignant type, Fifty-two percent of the patients had acute severe upper gastrointestinal bleeding as t he initial presentation of their tumor, The most common tumor was gast ric adenocarcinoma, and all of these cases were at advanced stages, En doscopic hemostasis with thermal probes or epinephrine injection, or b oth, was carried out in seven patients (17%), with successful hemostas is in all of the tumors, Regardless of the treatment given, patients w ith upper gastrointestinal tumor bleeding, had a 30-day surgery rate o f 43%, a 30-day rebleed rate of 33%, a 30-day mortality rate of 10%, a nd a 1-year mortality rate of 89%, Conclusions: Most tumors that cause severe upper gastrointestinal bleeding are of a malignant histologic type and are already at an advanced stage, Endoscopic hemostasis of bl eeding upper gastrointestinal tumors is safe and initially effective, and may provide time for elective surgical palliation, Regardless of t herapy, upper gastrointestinal tumors with severe bleeding have a poor one-year survival.