Background:

Peptic ulcer disease is the most common cause of hospitalization due to upper gastrointestinal bleeding. In 1974, J.A.H. Forrest described a classification based on the different endoscopic characteristics of gastroduodenal peptic ulcers with active or recent hemorrhage, which are associated with different risks.

Objective:

To classify by subgroups the patients who had hemorrhagic peptic ulcer and to determine the risk of recurrent hemorrhage, surgical treatment and mortality.

Temporary location:

January 01, 2015 to December 31, 2018.

Type of study:

Case series (descriptive, longitudinal, prospective, retrolective).

Results:

the study population consisted of 284 patients (N=284). The male sex 65.14% (n=185) and female. 34.86% (n=99). The average age was 62.03 + -17.72 years. The ulcers grade III constituted 51.76% of the patients (n=147), IIC 26.05% (n=74), IIB 12.67% (n=36), IIA 6.69% (n=19), IB 2.11% (n=6) and IA (0.7%). 77.81% (n=221) did not need endoscopic treatment. The groups with ulcers grade IA, IB, IIA and IIB were treated 44 of 63 patients, equal to 69.84%. Fifty percent of grade IIB ulcers were not given endoscopic treatment. The diluted adrenaline injection alone was used in 86.04%. The recurrence of hemorrhage occurred in 13.88% of ulcers grade IIB (5/36), 5.26% in ulcers grade IIA (1/19) and 2.7% in ulcers grade IIC (2/74). The surgical treatment corresponded to 0.7% (2/284). The overall mortality was 2.81% (8/284).

Conclusions:

In our hospital, the Forrest classification allowed us to stratify the risk in a practical and simple way, first establishing the diagnosis of the ulcer (s). The recurrence of hemorrhage was lower than that reported in the literature. The IIB risk subgroup should be given even more possibility of endoscopic treatment. Surgery is an alternative treatment in a frankly reduced number of patients. The percentage of mortality is low in patients with associated comorbidities.

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