Management of acute upper gastrointestinal hemorrhage.

Introduction Acute upper haemorrhage (UGIH) is a common medical emergency, with an incidence of up to 150 per 100,000. The incidence is highest in those from the lowest socio-economic groups. Although its incidence is declining, the mortality remains high. A large UK audit of UGIH in 1995 showed that in patients admitted with bleeding as their primary diagnosis the mortality was 11%. In contrast, in patients who had a ‘secondary’ UGIH (i.e. they had an UGIH whilst an in-patient for another reason) mortality was 33%. Most deaths from UGIH occur in the elderly population who have significant medical co-morbidities.