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Les hémorragies digestives ulcéreuses au CHU Hassan-II de Fès: approche épidémiologique

Bleeding peptic ulcers in the Fez Hassan-II Teaching Hospital: epidemiological approach

  • Article Original / Original Article
  • Published:
Journal Africain d'Hépato-Gastroentérologie

Résumé

But

Évaluer et préciser le profil épidémiologique des patients présentant des hémorragies digestives ulcéreuses au CHU Hassan-II de Fès, afin d’améliorer leur prise en charge.

Patients et méthodes

Sur une période de trois ans, tous les patients présentant une hémorragie digestive ulcéreuse ont été inclus dans cette étude. Une fiche comportant différentes variables a été élaborée, comportant différentes rubriques: la présence de comorbidités, la prise médicamenteuse, les différentes modalités thérapeutiques et enfin les taux de récidive hémorragique et de décès.

Résultats

Deux cent quatre-vingt-dix fiches étaient analysables. On avait noté une nette prédominance masculine (75,86 %, p < 0.05), d’un âge moyen de 47 ± 17 ans, avec une prise d’anti-inflammatoires non stéroïdiens chez 21 patients (9,5 %). Quatre-vingt-onze pour cent des ulcères étaient de siège bulbaire. Les ulcères hémorragiques de stades Ia, Ib et IIc de Forrest étaient notés dans 15,1 % des cas. Le traitement antisécrétoire était le plus souvent de l’oméprazole à forte dose (80 mg) par voie orale. Trentequatre patients (14,5 %) avaient récidivé, 17 (7 %) avaient bénéficié d’une chirurgie d’hémostase, aucune hémostase endoscopique n’a été réalisée et 11 patients (3,7 %) sont décédés. Seuls l’âge et le stade de Forrest étaient des facteurs prédictifs de récidive.

Conclusion

Les hémorragies ulcéreuses au CHU de Fès sont moins sévères que celles des pays développés et, cela, à cause d’un profil épidémiologique différent. L’âge et le stade de Forrest sont des facteurs prédictifs de récidive hémorragique.

Abstract

Aim

Evaluate and refine the epidemiological profile of patients presenting bleeding peptic ulcers at the Fez Hassan-II Teaching Hospital, in order to improve their health care.

Patients and methods

Over a period of three-years, all patients presenting a bleeding peptic ulcer were included in this study. An identification form was elaborated. The form includes different variables such as: presence of comorbidity, medicines taken, different therapies and rates of hemorrhagic relapse and death.

Results

Two hundred ninety identification forms were analysed. Male predominance (75.86%) was noted, with an average age of 47 ± 17 years and the use of non-steroidal anti-inflammatory drugs by 21 patients (9.5%). Ninety-one percent of the ulcers were located in the bulb. Bleeding ulcers at Forrest stages Ia, Ib and II were noted in 15.1% of cases. Anti-secretory treatment was most often omeprazole, taken orally. Thirty-four patients (14.5%) had relapsed, 17 (7%) had undergone haemostatic surgery, and no patient was treated by endoscopic hemostasia. Eleven patients (3.7%) died. Only age and Forrest stages were the factors predicting relapse.

Conclusion

Cases of bleeding peptic ulcers at the Fez Hassan-II Teaching Hospital were less severe than in developed nations and this is because of a different epidemiological profile. Age and Forrest classification are predictive factors of relapse bleeding.

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Authors and Affiliations

  1. Service d’hépatogastroentérologie, CHU Hassan-II, BP 1731, 30003, Atlas, Fès, Maroc

    D. -A. Benajah, N. Aqodad, M. El Abkari & A. Ibrahimi

  2. Laboratoire d’épidémiologie et de santé publique, faculté de médecine de Fès, CHU Hassan-II, 30003, Fès, Maroc

    S. El Fakir & C. Nejjari

Authors
  1. D. -A. Benajah
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  2. N. Aqodad
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  3. S. El Fakir
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  4. M. El Abkari
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  5. C. Nejjari
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  6. A. Ibrahimi
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Correspondence to D. -A. Benajah.

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Benajah, D.A., Aqodad, N., El Fakir, S. et al. Les hémorragies digestives ulcéreuses au CHU Hassan-II de Fès: approche épidémiologique. J Afr Hepato Gastroenterol 3, 16–21 (2009). https://doi.org/10.1007/s12157-009-0067-z

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  • DOI: https://doi.org/10.1007/s12157-009-0067-z

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