Cancer and Upper Gastrointestinal Tract Hemorrhage

Abstract

The sources of upper gastrointestinal tract bleeding have been documented by endoscopy in 81 patients studied prospectively at Memorial Sloan-Kettering Cancer Center from 1969 to 1972. Hemorrhagic gastritis was most common cause of bleeding overall in 38 patients (47%), followed by chronic peptic ulcer disease in 18 patients (22%). Bleeding directly from tumor was present in only 10 patients (12%). Eighteen stomach tumors were seen endoscopically, but only ten were bleeding. Primary gastric carcinoma and secondary gastric lymphoma were likely to be the origin of hemorrhage, while other metastatic tumors were unlikely sources. Stress ulcers were important, accounting for more than half of the hemorrhagic gastritis in patients with malignant disease. The remaining cases of gastritis were associated with exogenous gastric irritants. These results indicate need for aggressive diagnostic approaches, with early endoscopy for patients with cancer who develop upper gastrointestinal tract bleeding.