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      Gastrointestinal bleeding in patients with acute spinal injuries.

      International rehabilitation medicine
      Acute Disease, Adolescent, Adult, Aged, Anticoagulants, adverse effects, Gastrointestinal Hemorrhage, chemically induced, etiology, psychology, Humans, Male, Middle Aged, Peptic Ulcer, Retrospective Studies, Smoking, Spinal Cord Injuries, complications

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          Abstract

          439 acute, male, spinal injury patients were admitted over an 11-year period at the National Spinal Injuries Centre: 206 cervical, 182 dorsal, and 51 lumbar cord injuries. 27 patients had gastrointestinal bleeds; 20 bled on one occasion, 7 had more than one episode; 22 bled within 4 weeks of injury. The mean was 22.5 days. The presentation was mostly malaena. A diagnosis was made in 19 cases; 12 had duodenal ulcers, 4 gastric ulcers, 1 had gastritis, 1 had a gastric carcinoma, 1 had oesophagitis with a possible Mallory-Weiss tear; 4 died. The incidence was higher in cervical patients. Causation was thought to be due to patients being sick from severe intercurrent illnesses and injuries. Implications for further research are discussed.

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