Licensed books on medicine
<< Previous || Next >> |
Gastrointestinal bleeding is a problem that doctors in the USA often encounter (300 thousand hospitalizations annually). The degree of hemorrhage varies from small slow bleeding to life-threatening conditions that contribute to the development of iron deficiency anemia. Mortality from upper gastrointestinal tract in the USA is 8%. This indicator has not changed much over the past 40 years, but it can be assumed that it tends to decrease, taking into account the general aging of the population and the fact that the risk of mortality from bleeding in older people is increased. New treatment methods have reduced the number of deaths from bleeding from the lower gastrointestinal tract.
As a rule, bleeding from the gastrointestinal tract stops on its own, however, with prolonged severe bleeding, the likelihood of death is quite high and the use of surgical methods of treatment is often required. The main role in successful treatment for bleeding is played by a quick assessment of the severity of the patient's condition and the implementation of measures to stabilize hemodynamics. Only then a thorough diagnosis and prevention of repeated bleeding is carried out.
| << Previous || Next >> |
| = Skip to textbook content = |
- Bleeding in gastric ulcer as an example of bleeding from the upper gastrointestinal tract
Gastric and duodenal ulcers cause about 50.% of cases of bleeding from the upper gastrointestinal tract (Table 9-2). Despite the introduction of new effective methods of treating peptic ulcer in the past 15 years, the frequency of bleeding with this pathology has not practically decreased. One of the reasons for this situation is the fact that often peptic ulcer
- Acute and chronic bleeding from the gastrointestinal tract
There are many causes of gastrointestinal bleeding. Bleeding develops according to one of two primary mechanisms: 1. Violation of the integrity of the mucous membrane, leading to exposure of deep vessels, their erosion. For example, bleeding from a stomach ulcer, bleeding from the intestines during infectious or idiopathic processes, from the small and large intestines during ischemia. 2.
- Bleeding from the upper gastrointestinal tract
It is customary to talk about bleeding from the upper gastrointestinal tract (GIT) in cases where the source of bleeding is located either in the esophagus, or in the stomach, or in the duodenum (duodenum). Pathophysiology The most common causes of bleeding in adults are: duodenal ulcer; erosion of the stomach and duodenum; varicose veins
- Prognosis for bleeding from the upper gastrointestinal tract
There are several criteria for poor prognosis for bleeding from the upper gastrointestinal tract. The most important is the cause of the bleeding. So, for bleeding from varicose veins, the highest frequency of repeated bleeding (relapses) and deaths is characteristic. In primary hospitalization, mortality in this type of bleeding is 30%, with repeated - 50-70%.
- The principles of treatment of bleeding from the gastrointestinal tract with portal hypertension
Bleeding from varicose nodes is the most abundant of all types of bleeding that occurs in the upper parts of the gastrointestinal tract, in which the patient requires emergency medical care. In more than 90% of cases of such bleeding, the hematocrit level drops sharply and becomes less than 30% of normal, resulting in the need for
- Diagnosis of bleeding from the gastrointestinal tract
Diagnosis of gastrointestinal bleeding
- Etiology of bleeding from the lower gastrointestinal tract
Lesions in the anal region and rectum. Small amounts of bright red blood on the surface of feces and toilet paper often appear with hemorrhoids; bleeding in this case is usually aggravated by the difficult passage of solid feces. Similarly, fissures and fistulas in the anal region can occur. Another source of rectal bleeding is proctitis; he
- Vascular ectasia as an example of chronic bleeding from the gastrointestinal tract
Vascular ectasia, or angiodysplasia, is one of the common causes of both profuse and minor prolonged bleeding from the lower gastrointestinal tract. Most of them are associated with age-related degenerative changes in the vascular wall in the elderly. In other age groups, vascular wall disorders can be congenital. Two thirds of patients with angio dysplasia
- Gastrointestinal Lymphoma
In systemic dissemination of non-Hodgkin lymphoma (see chapter 13), any segment of the gastrointestinal tract may be involved again. However, up to 40% of lymphomas develop not in the lymph nodes, but in other organs, among which the intestine is the most frequent localization. By the time of recognition of the primary lymphoma of the gastrointestinal tract, the tumor process does not affect either the liver or
- Gastrointestinal metabolism
Liquid and electrolytes are excreted in large quantities with digestive secretions in the gastrointestinal tract, but under normal conditions they are mostly reabsorbed (Fig. 20). Fig. 20. Secretion of water and electrolyte (meq / l of the amount of secretion indicated in the table) (Geigy). Potassium is excreted in the intestines (especially in the large intestine), and it is replaced during the exchange process with sodium (Gooptu with