ON THE ISSUE OF CLASSIFICATION OF MALLORY-WEISS SYNDROME

Abstract

Aim of the study was to improve the treatment outcomes of patients with Mallory-Weiss syndrome by systematizing the clinical signs of the disease and a differentiated approach to the choice of treatment method. Materials and methods: The results of examination and treatment of 112 patients with Mallory- Weiss syndrome. All patients were divided into two clinical groups - control and main. The control group included 64 patients who underwent traditional treatment approaches. In the main group, 48 patients We have carried out an improved set of therapeutic measures. Results. We have systematized the classification of Mallory-Weiss syndrome according to the localization of the lesion; by the length, number and length of ruptures; bleeding intensity. I. By the location of the lesion: EF type (esophageal fissure) - Lower third of the esophagus; KEF type (kardioesophageal fissure) - Cardio-esophageal transition; KESF type (kardioesophageal-stomach fissure) is a cardio-esophageal transition that spreads to the gastric mucosa; HF type (hernial fissure) is a fissure inside a hiatal hernia. II. By the Number of Gaps: Single; Plural. III. By the length of the gap: Small - up to 1.0 cm; Medium - from 1.0 to 2.0 cm; Large - more than 2.0 cm. IV. By the depth of the defect: Stage 1 - rupture of the mucous membrane; Stage 2 - rupture of the mucous membrane and submucosal layer; Stage 3 - rupture with involvement of the circular muscle layer; Stage 4 - rupture of all layers of the esophagus. V. By the intensity of bleeding: Grade 1 - ongoing bleeding (1a - jet, profuse arterial bleeding, the source is not visible due to the inability to sanitize the esophagus from blood; 1b - jet, arterial bleeding, the possibility of debridement of the esophagus makes it possible to determine the source of bleeding; 1с - venous bleeding, no blood clots; 1d - the fissure is covered with fresh blood clots, there is a blood spurt under them). Grade 2 - stopped bleeding (2 a - visible thrombosed vessel in the area of rupture; 2 b - fixed clot in the rupture area without bleeding; 2 c - the rupture is covered with fibrin). Grade 3 - rupture without signs of bleeding, granulation of the fissure.