Upper GI bleed: common causes included peptic ulcers and Mallory-Weiss tears

Clinical bottom line (level 4)

  1. Common causes of upper GI bleeding included peptic ulcers and Mallory-Weiss tears.
Masson et al: Journal of the Royal College of Physicians of London 1996; 30 (5): 436-442
Expires January 2003

The study

Setting: acute hospital, UK

1098 patients (aged ?, ?% male) with confirmed upper GI bleeding

Independent unblinded reference standard, applied in all patients from a ?consecutive ?appropriate spectrum.
Reference standard:
  • endoscopy, surgery or postmortem

The evidence


differential diagnosis number of patients prevalence
(95% CI)
duodenal ulcer 275 25%
(22% to 28%)
oesophagitis/ulcer 180 16%
(14% to 19%)
gastric ulcer 151 14%
(12% to 16%)
Mallory-Weiss tear 113 10%
(8.5% to 12%)
gastric erosions 90 8.2%
(6.6% to 9.8%)
varices 59 5.4%
(4.0% to 6.7%)
gastric or oesophageal cancer 27 2.5%
(1.5% to 3.4%)
duodenitis 21 1.9%
(1.1% to 2.7%)
others 59 5.4%
(4.0% to 6.7%)
no cause found 67 6.1%
(4.7% to 7.5%)

Citation

  1. Masson J, Bramley PN, Herd K, et al: Upper gastrointestinal bleeding in an open-access dedicated unit. Journal of the Royal College of Physicians of London 1996; 30 (5): 436-442
Contributor: Sharon Straus and Chris Ball, Unknown Month 1999
Reviewer: Lawrence Friedman

Clinical Question.
Patient upper GI bleeding
Intervention or Exposure assessment
Outcome cause