<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2011-7582</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[rev. colomb. cir.]]></abbrev-journal-title>
<issn>2011-7582</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2011-75822025000300544</article-id>
<article-id pub-id-type="doi">10.30944/20117582.2794</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hemorragia digestiva masiva: redescubriendo un titán quirúrgico del siglo XX en un hospital de referencia del suroccidente colombiano]]></article-title>
<article-title xml:lang="en"><![CDATA[Massive gastrointestinal bleeding: rediscovering a surgical titan of the 20th century in a reference hospital in southwestern Colombia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Capre-Pereira]]></surname>
<given-names><![CDATA[Jessica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salcedo]]></surname>
<given-names><![CDATA[Alexander]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Holguín]]></surname>
<given-names><![CDATA[Juan Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Imbachí]]></surname>
<given-names><![CDATA[Helber Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arroyave]]></surname>
<given-names><![CDATA[Cristhian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caicedo]]></surname>
<given-names><![CDATA[Yaset]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bejarano]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cortés-Maya]]></surname>
<given-names><![CDATA[Jorge Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kestenberg]]></surname>
<given-names><![CDATA[Abraham]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Fundación Valle del Lili Servicio de Cirugía de Colon y Recto ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad ICESI Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario Fundación Valle del Lili Departamento de Cirugía ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario Fundación Valle del Lili Centro de Investigaciones Clínicas ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Universitario del Valle E.S.E Departamento de Cirugía ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Universidad ICESI Programa de subespecialización en Cirugía de Colon y Recto ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Universidad ICESI Programa de especialización en Cirugía General ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Hospital Universitario Fundación Valle del Lili Departamento de Cirugía ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Hospital Universitario del Valle E.S.E  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<volume>40</volume>
<numero>3</numero>
<fpage>544</fpage>
<lpage>554</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S2011-75822025000300544&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S2011-75822025000300544&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S2011-75822025000300544&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción.  El espectro de presentación de la hemorragia digestiva ha cambiado en el tiempo y aunque la frecuencia de la hemorragia digestiva masiva (HDM) se ha reducido, continúa siendo una entidad relevante al tener una mortalidad elevada y requerir mayor esfuerzo terapéutico para su control. El objetivo de este estudio fue analizar las características de los pacientes con HDM y los factores asociados a su ocurrencia.  Métodos.  Estudio analítico de cohorte retrospectiva (2012-2022) en pacientes con diagnóstico de hemorragia digestiva confirmado por endoscopia. Se definió HDM como la necesidad de transfusión de 2 o más unidades de glóbulos rojos. Se evaluaron factores demográficos, comorbilidades y estado hemodinámico. Se hizo un análisis multivariado para identificar los factores asociados a HDM.  Resultados.  Se incluyeron 259 pacientes, de los cuales 62 (23,9 %) presentaron HDM. La mortalidad en los pacientes con HDM fue del 30,6 %. El análisis multivariado demostró que un puntaje en la escala de coma de Glasgow menor o igual a 13 (aOR 2,85; IC95% 1,17-6,94), un índice de shock mayor de 0,9 (aOR 2,19; IC95% 1,07-4,54) y el antecedente de diabetes complicada (aOR 3,36; IC95% 1,15-9,74) fueron los factores que se asociaron con HDM.  Conclusiones.  La alteración del estado de conciencia, el aumento del índice de shock y el antecedente de diabetes complicada en la evaluación inicial de un paciente con sangrado digestivo deben alertar sobre una posible HDM. La necesidad de transfusión, angioembolización, procedimientos endoscópicos o cirugía deben considerarse tempranamente al tratar los pacientes con HDM.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction.  The spectrum of presentation of gastrointestinal bleeding has changed over time, and although the incidence of massive gastrointestinal bleeding (MGIB) has decreased, it continues to be a relevant entity as it has a high mortality rate and requires greater therapeutic effort required to control. The objective of this study was to analyze the characteristics of patients with (MGIB) and the factors associated with its occurrence.  Methods.  Retrospective analytical cohort study (2012-2022) in patients with a diagnosis of gastrointestinal bleeding confirmed by endoscopy. (MGIB) was defined as the need for transfusion of 2 or more units of red blood cells. Demographic factors, comorbidities and hemodynamic status were assessed. A multivariate analysis was performed to identify the factors associated with (MGIB).  Results.  A total of 259 patients were included, of which 23.9% presented (MGIB). Mortality in patients with (MGIB) was 30.6%. The multivariate analysis showed that a Glasgow, score of &lt; 13 (aOR 2.85; 95% CI 1.17-6.94), a shock index &gt; 0.9 (aOR:2.19; 95% CI 1.07-4.54) and a history of complicated diabetes (aOR: 3.36; 95% CI 1.15-9.74) were the factors associated with (MGIB).  Conclusions.  Altered consciousness, increased shock index and a history of complicated diabetes in the initial presentation of gastrointestinal bleeding should alert to the possibility of (MGIB). The need for transfusion, angioembolization, endoscopic procedures, or surgery should be considered early when treating patients with (MGIB).]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hemorragia gastrointestinal]]></kwd>
<kwd lng="es"><![CDATA[enfermedades gastrointestinales]]></kwd>
<kwd lng="es"><![CDATA[endoscopia gastrointestinal]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="es"><![CDATA[transfusión de componentes sanguíneos]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="en"><![CDATA[gastrointestinal bleeding]]></kwd>
<kwd lng="en"><![CDATA[gastrointestinal diseases]]></kwd>
<kwd lng="en"><![CDATA[gastrointestinal endoscopy]]></kwd>
<kwd lng="en"><![CDATA[risk factors]]></kwd>
<kwd lng="en"><![CDATA[blood component transfusion]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
</kwd-group>
</article-meta>
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