DOI: https://doi.org/10.22263/2312-4156.2016.3.40
Bogdanovich A.V., Shilenok V.N., Zeldin E.Y.
Structure and tactics of the treatment of bleedings from the upper parts of the gastrointestinal tract
Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Vitebsk, Republic of Belarus
Vestnik VGMU. 2016;15(3):40-46.
Abstract.
Objectives. To study the structure of bleedings from the upper parts of the gastrointestinal tract, to make an analysis of the diagnostic and therapeutic tactics.
Material and methods. The results of the diagnosis and treatment of 1548 patients with gastroduodenal bleedings admitted to the surgical department of the Vitebsk Town Acute Hospital over the period from 2009 to 2014 were studied. Peptic etiology bleedings were observed in 1127 (72,8%), Mallory-Weiss syndrome in 260 (16,8%), erosive and hemorrhagic gastroduodenitis and Delafua syndrome in 45 (2,9%), varicose veins of the esophagocardial zone on the background of portal hypertension in 116 (7,5%) patients.
Results. Treatment of patients with continuing ulcer bleedings began with endoscopic hemostasis. When endoscopic hemostasis was ineffective and there was a recurrence of profuse bleeding emergency surgery was performed on absolute grounds. Stable endoscopic hemostasis was achieved in 72 (92,3%) patients in Mallory-Weiss syndrome, the recurrence of bleeding was observed in 5 (6,4%) cases. In 8 patients with Delafua syndrome endoscopic hemostasis was ineffective. In case of bleeding from esophageal and gastric varicose veins on the background of portal hypertension the treatment strategy was conservative with the use of Blackmore’s probe.
Conclusions. In the structure of bleedings from the upper parts of the gastrointestinal tract gastric and duodenal ulcers occur most frequently. Endoscopic hemostasis is effective for bleeding ulcers and in Mallory-Weiss syndrome, it is less effective in case of bleeding from varicose veins, Delafua angiodysplasia.
Key words: bleeding, ulcer, endoscopic hemostasis, Mallory-Weiss syndrome, Delafua syndrome.
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Information about authors:
Bogdanovich A.V. – Candidate of Medical Sciences, associate professor of the Chair of Faculty Surgery, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University»;
Shilenok V.N. – Doctor of Medical Sciences, professor, head of the Chair of Faculty Surgery, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University»;
Zeldin E.Y. – Candidate of Medical Sciences, associate professor of the Chair of Faculty Surgery, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University».
Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Chair of Faculty Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Bogdanovich A.V.
