Factors contributing to bleeding
and perforated peptic ulcers in Syria: findings
from a multicenter cohort study
Dublin Core
Title
Factors contributing to bleeding
and perforated peptic ulcers in Syria: findings
from a multicenter cohort study
and perforated peptic ulcers in Syria: findings
from a multicenter cohort study
Subject
Keywords Peptic‐ulcer, Bleeding, Perforation, Syria, Conflict‐zone, Epidemiology, Gastric, Duodenal
Description
Abstract
Background Peptic ulcer disease (PUD) is a common gastrointestinal disorder characterized by the formation of
open lesions in the stomach or duodenum, leading to potentially life-threatening complications such as bleeding,
perforation, and obstruction. Despite advances in understanding its pathophysiology and management, PUD
continues to present significant health challenges, particularly in conflict-affected regions like Syria. This study
investigates clinical presentation, demographic factors, and risk profiles associated with bleeding and perforated
ulcers, aiming to contribute to evidence-based strategies for improving diagnosis and management in resource-
limited settings.
Methods A multicenter cohort study was conducted across five major hospitals in Syria from 2018 to 2023, enrolling
242 patients diagnosed with bleeding or perforated ulcers. Demographic data, clinical histories, lifestyle factors, and
medical interventions were collected from hospital records. Statistical analyses, including Chi-square tests, t-tests, and
logistic regression, were performed to identify associations between ulcer types, demographic variables, and clinical
outcomes.
Results Significant demographic differences were found between patients with bleeding and perforated ulcers. The
bleeding group was older (mean age=60.4±18.7 years) compared to the perforation group (mean age=49.4±16.9
years), with rural residents more likely to experience bleeding ulcers (57.3%). Patients with a past history of peptic
ulcer disease, gastritis, or other upper‐GI disorders were more likely to develop perforated ulcers, while those with
multiple comorbidities were predisposed to bleeding ulcers. Lifestyle factors, such as occupation and smoking status,
also influence ulcer type, with retired individuals more likely to develop bleeding ulcers and heavy smokers more
often diagnosed with perforation. Clinical outcomes varied, with interventions predominantly consisting of open
surgeries for perforated ulcers and laparoscopic approaches for bleeding ulcers.
Background Peptic ulcer disease (PUD) is a common gastrointestinal disorder characterized by the formation of
open lesions in the stomach or duodenum, leading to potentially life-threatening complications such as bleeding,
perforation, and obstruction. Despite advances in understanding its pathophysiology and management, PUD
continues to present significant health challenges, particularly in conflict-affected regions like Syria. This study
investigates clinical presentation, demographic factors, and risk profiles associated with bleeding and perforated
ulcers, aiming to contribute to evidence-based strategies for improving diagnosis and management in resource-
limited settings.
Methods A multicenter cohort study was conducted across five major hospitals in Syria from 2018 to 2023, enrolling
242 patients diagnosed with bleeding or perforated ulcers. Demographic data, clinical histories, lifestyle factors, and
medical interventions were collected from hospital records. Statistical analyses, including Chi-square tests, t-tests, and
logistic regression, were performed to identify associations between ulcer types, demographic variables, and clinical
outcomes.
Results Significant demographic differences were found between patients with bleeding and perforated ulcers. The
bleeding group was older (mean age=60.4±18.7 years) compared to the perforation group (mean age=49.4±16.9
years), with rural residents more likely to experience bleeding ulcers (57.3%). Patients with a past history of peptic
ulcer disease, gastritis, or other upper‐GI disorders were more likely to develop perforated ulcers, while those with
multiple comorbidities were predisposed to bleeding ulcers. Lifestyle factors, such as occupation and smoking status,
also influence ulcer type, with retired individuals more likely to develop bleeding ulcers and heavy smokers more
often diagnosed with perforation. Clinical outcomes varied, with interventions predominantly consisting of open
surgeries for perforated ulcers and laparoscopic approaches for bleeding ulcers.
Creator
Jamal Ataya1* , Yaman Haj Hasan1† , Rawan Daboul2† , Hamdah Hanifa3 , Nour Bannoud4 ,
Nour Alhuda Abd Alnabi5
, Masa Watfa6 , Mohammed Jomaa7
, Hamoud Hamed8
and Ahmad Alhaj9
Nour Alhuda Abd Alnabi5
, Masa Watfa6 , Mohammed Jomaa7
, Hamoud Hamed8
and Ahmad Alhaj9
Source
https://doi.org/10.1186/s12245-025-01024-w
Date
2025
Contributor
Peri Irawan
Files
Collection
Citation
Jamal Ataya1* , Yaman Haj Hasan1† , Rawan Daboul2† , Hamdah Hanifa3 , Nour Bannoud4 ,
Nour Alhuda Abd Alnabi5
, Masa Watfa6 , Mohammed Jomaa7
, Hamoud Hamed8
and Ahmad Alhaj9, “Factors contributing to bleeding
and perforated peptic ulcers in Syria: findings
from a multicenter cohort study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12862.
and perforated peptic ulcers in Syria: findings
from a multicenter cohort study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12862.