Treatment of acute erosive-ulcerative gastroduodenal bleeding

Abstract

To date, the tactics of treating patients with acute erosive-ulcerative gastroduodenal bleeding remains one of the most actual problem of urgent surgery. According to various authors, acute erosion and ulcers of the mucous membrane of the gastroduodenal zone are detected about 5-10% during endoscopic examination [1, 2]. In most published works, bleeding from acute ulcers is often treated as a peptic ulcer, using the same therapeutic and tactical techniques. The clinical course of acute ulcers differs from the manifestations of peptic ulcer. Material and methods: We analyzed 215 clinical cases with acute erosive-ulcerative bleeding, which were received by the emergency surgery department of the clinic of the Tashkent Medical Academy for the period from 2014 to 2021 yy. The age of patients ranged from 18 to 83 years. Results and discussion: Among patients undergoing endoscopic manipulations, the final hemostasis was achieved in 53 (88.3%) cases. Recurrence bleeding was noted in 7 (11.7%) cases. After repeated endoscopic intervention in 3 cases, the bleeding was finally stopped. 4 (1.9%) patients, due to the inefficiency of endoscopic methods of hemostasis in an extremely serious condition, were taken for surgery ongoing bleeding. Conclusions: Endoscopic methods of hemostasis are effective for bleeding (especially F-I-A, F-I-B, F-II-A degrees) from acute ulcers and erosion of the upper gastrointestinal tract, with the frequency of final hemostasis up to 93.3%; The use of combined methods and retrograde hemostasis in the position on the “right side” made it possible to stop bleeding in 90% of cases; With the ineffectiveness of endoscopic methods, it is necessary to resort to open surgery.