THE NATURAL-HISTORY (FADING TIME) OF STIGMATA OF RECENT HEMORRHAGE INPEPTIC-ULCER DISEASE

From October 1991 to December 1992, 144 patients with bleeding peptic ulcer and stigmata of recent hemorrhage were included in a study desig ned to investigate, by means of endoscopic examinations repeated at 2- day intervals, the evolutionary development of stigmata of recent hemo rrhage, such as visible vessels, and to determine the time required fo r each type of stigma to fade. Eighty-five patients underwent endoscop ic follow-up until the stigmata had disappeared. A visible vessel take s about 4.1 +/- 2.1 days to disappear, requiring significantly more ti me than an adherent clot or an old stigma, which take 2.4 +/- 0.8 days and 2.4 +/- 1.3 days, respectively (p < .05). Bleeding does not recur after stigmata disappear. Time required for stigmata to fade is not a ffected by age, sex, smoking, history of peptic ulcer, ulcer location, severe bleeding, underlying systemic disease, or endoscopic local the rapy. While healing, stigmata of recent hemorrhage evolve through a se quence of phases: a visible vessel may or may not appear as an adheren t clot and then as a red or black flat spot before disappearing.