DOI: 10.25881/BPNMSC.2020.61.63.007

Authors

Valeev M.V.1, Timerbulatov SH.V.2

1 Central District Hospital of Beloretsk, Beloretsk

2 Bashkir State Medical University, Ufa

Abstract

Aims. To analyze the results of treatment of patients with nonvariceal upper gastrointestinal bleeding in the conditions of the central district hospital (in the absence of technical capabilities for endoscopic hemostasis).

Methods. The analysis of the treatment results of 472 patients with nonvariceal upper gastrointestinal bleeding who were hospitalized in the Beloretsk Central District Hospital from 2008 to 2018 was carried out. During this period, the clinic lacked technical capabilities for performing endoscopic hemostasis.

Results. As a source of bleeding, the peptic ulcers (50.8%) and Mallory-Weiss tears (37.3%) take the leading place. Following are the erosive lesions of the esophagus, stomach and duodenum (9.3%). Surgical treatment for peptic ulcer bleeding was performed in 22.9% of cases, with Mallory-Weiss tears — in 4%. Rebleeding was characteristic of peptic ulcer disease (21.7%) and Mallory-Weiss tears (5.7%). Mortality with peptic ulcer bleeding was 6.3%, with Mallory-Weiss tears — 1.7%.

Conclusion. 1. Of the whole variety of nonvariceal upper gastrointestinal bleeding, ulcer bleeding and Mallory-Weiss tears remain the most relevant for the surgeon today. 2. Rebleeding with peptic ulcer and Mallory-Weiss tears is one of the main risk factors for the development of a fatal outcome, increasing mortality tenfold. 3. In the absence of endoscopic hemostasis in the treatment of ulcerative bleeding, the most preferred is active surgical tactics. 4. An unusual cause of the development of Mallory-Weiss tears is an exacerbation of peptic ulcer.

Keywords: upper gastrointestinal bleeding, the peptic ulcer bleeding, Mallory-Weiss tear.

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For citation

Valeev M.V., Timerbulatov SH.V. Upper gastrointestinal bleeding. Analysis of the results of treatment in a district hospital. Bulletin of Pirogov National Medical & Surgical Center. 2020;1(15):39-42. (In Russ.) https://doi.org/10.25881/BPNMSC.2020.61.63.007