[Iatrogenic gastrointestinal hemorrhages. A review of 108 cases (author's transl)]

Abstract

Macroscopic gastrointestinal hemorrhages caused by the consumption of oral drugs are relatively scarce among patients receiving antirheumatic treatment. On the other hand, in a high percentage of all cases of digestive bleeding, antirheumatic drugs were administered shortly beforehand. A review of 216 cases with hematemesis and/or melena are presented. In 50 percent of the patients there was evidence of previous administration of potentially ulcerogenic drugs capable of causing hemorrhages in the digestive tract. Salicylates predominated among the compounds that were considered to be responsible for hemorrhages (salicylates, corticosteroids, reserpine, and other antirheumatic products). The mechanisms involved in producing iatrogenic hemorrhages were examined and the drugs were classified as precipitating and directly ulcerogenic compounds. Precipitating drugs were those which were able to reactivate a preexisting lesion (reserpine, glucocorticoids, phenylbutazone, etc.). The ulcerogenic drugs included those products that could provoke a lesion of previously unimpaired digestive mucosa (salicylates).