INCIDENCE OF PEPTIC-ULCERS IN PATIENTS WI TH ARTERIAL OCCLUSIVE DISEASE - AN ADDITIONAL RISK FACTOR

Acute bleeding of the upper gastrointestinal tract found in patients w ith arterial occlusive disease lead us to analyse the coincidence of a rterial occlusive disease and pathological changes of the upper gastro intestinal tract. While waiting for reconstructive vascular surgery be tween 1986 and 1992 420 patients underwent esophago-gastro-duodenoscop y for preoperative risk assessment. In 59 % endoscopy revealed patholo gical findings in the upper gastrointestinal tract. Inflammation was f ound in 61,6 % of the patients, in 15 % gastric ulcer. Patients with g astrointestinal symptoms had no significant more pathological findings in gastroscopy (p=0.1). We excluded 9.3% patients from primary electi ve vascular surgery because of their severe pathological findings. 19 patients were operated on their gastrointestinal disease at first. In 7 patients we found an unknown carcinoma of the stomach. 5 patients go t a resection of the stomach, in 2 patients an operation was unable. T he diagnosis and therapy of risk factors are a major objective in the treatment of arterial occlusive disease. The results of the study stre ss the necessity of routinely performed endoscopy in patients awaiting vascular surgery. Beside a preoperative risk assessment this will lea d to a lower incidence of serious gastrointestinal complications posto peratively.