Bleeding gastrointestinal
Bleeding gastrointestinal . In 85% of cases, the source of bleeding is located in the esophagus, stomach or duodenum, in 14% in the colon and in 1% in the small intestine. Bleeding from the upper part of the digestive tract may be caused by peptic ulcer of the stomach or duodenum (68%), varicose veins of the esophagus and cardiac part of the stomach (12%), erosive gastritis, Mallory-Weiss syndrome, polyps, cancerous tumors, etc. (20 %). In the small and large intestine, bleeding can be caused by diverticula of the small and large intestine, polyps, cancer, sarcoma, angioma, myoma, carcinoid, ulcerative colitis, Crohn's disease, ruptured aortic aneurysms or mesenteric vessels, thrombosis and embolism of mesenteric vessels.
Symptoms are caused by local manifestations of bleeding (vomiting "coffee grounds" or tarry stools) and common phenomena caused by a decrease in the volume of circulating blood. Local manifestations of bleeding: when the source of bleeding is localized in the proximal part of the stomach, vomiting first "coffee grounds", and then unchanged blood with clots. When the source is localized in the prepiloric and antral parts of vomiting, only the "coffee grounds". At the post-piloric source of bleeding, a tarry stool is characteristic; Vomit "coffee grounds" does not happen, if there is no massive transfer of blood through the gatekeeper into the stomach. When bleeding from the small intestine and the right half of the colon in the feces contains dark blood. Bleeding from the left side of the colon is accompanied by the release of unchanged blood. Massive hemorrhage is often manifested by syncope, tachycardia, a sharp decrease in blood pressure, up to a collapse. In the first hours after bleeding, its severity can be judged by the level of hematocrit and the deficiency of BCC; Reduction in the number of erythrocytes in the peripheral blood and hemoglobin level occurs within 12-24 hours. The simplest method for determining the deficit of bcc is the Algover method, which consists in evaluating the shock index, which is a fraction of the pulse rate divided by the magnitude of systolic pressure From 20 to 60 years). Shock index 0.5 indicates a loss of bcc of 15%, an index of 1.0-30%, an index of 2.0-70%. It is also informative to study the dynamics of central venous pressure.
Treatment should include several concurrent activities: 1) replenishment of BCC, i.e., control of hypovolemic shock; 2) clarification of the source of bleeding and its localization; 3) the final stop of bleeding.
- Surgical diseases
- Abscess
- Abscess appendicular
- Abscesses of the abdominal cavity
- Abscess of the Douglas space
- Intestinal abscess
- Abscess of the lung
- Soft tissue abscess
- Abscesses of soft tissues after injection
- Abscess of liver
- Amoebic liver abscess
- Prostate adenoma
- Actinomycosis
- Aneurysm
- False aneurysm
- True aneurysms
- Aneurysm of the aortic arch
- Aneurysm of descending thoracic aorta
- Dissecting Aneurysm
- Aneurysm of the abdominal aorta
- Aneurysm of peripheral vessels
- Arteriovenous aneurysm
- Aneurimas of the heart
- Appendicitis acute
- Perforation of the appendage
- Appendicular infiltration
- Pielephlebitis
- Atheroma
- Bronchoectasis
- Varicose veins
- Varicose veins of the spermatic cord
- Dropsy of testis and spermatic cord
- Rectal prolapse
- Gangrene gas
- Gangrene lung
- Hemorrhoids
- Hydradenite
- Gynecomastia
- Hernia
- Internal hernias
- Hernias of the esophagus
- External hernias
- Herniated hernias
- Herniated hernia
- Hernia of the white line
- Hernia postoperative ventral
- Herniated hernia
- Rare hernias
- Pincushion
- Phlegmon hernial sac
- False infringement of a hernia
- Hernias with inflammation
- Dumping syndrome
- Diverticulum
- Esophagus diverticulum
- Cervical diverticulum
- Bifurcation diverticulum
- Epiphrenial diverticulum
- Epiphrenial diverticulum
- Diverticulum of the stomach
- Diverticulum of the duodenum
- Meckel's diverticulum
- Jaundice mechanical
- Bile duct stones
- Ventilated stone of choledoch
- Papillotenosis
- Stricture of bile ducts
- Cancer of the head of the pancreas
- Cholelithiasis
- Urinary retention acute
- Zollinger-Ellison syndrome
- Foreign bodies of bronchi
- Foreign bodies of the stomach
- Foreign bodies of the esophagus
- Foreign bodies of soft tissues
- Carbuncle
- Brushes and fistulas of the neck are lateral
- Cysts and fistulas of the neck median
- Colitis ulcerative ulcerative
- Coccygeal epithelial passage
- Cryptorchidism
- Bleeding
- Bleeding internal
- Varicose veins
- The Mallory-Weiss Syndrome
- Bleeding into the abdominal cavity
- Bleeding pulmonary
- Bleeding external
- Parenchymal hemorrhage
- Crohn's disease
- Lymphadenitis
- Lymphangitis
- Mastitis
- Putrefactive mastitis
- Acute non-lactational mastitis
- Chronic mastitis
- Megacolon
- Mediastinitis
- Intestinal obstruction
- Paralytic intestinal obstruction
- Mechanical intestinal obstruction
- X-ray diagnostics
- Specific types of intestinal obstruction
- Ingrown throat
- Frostbite
- Local cooling
- Burn
- Occlusion of the main arteries
- Acute occlusion of the vessels of the extremities
- Acute occlusion of mesenteric vessels
- Chronic occlusions of arterial vessels
- Obtiterating atherosclerosis
- Aortic ileal type
- Hips and popliteal type
- Peripheral type
- Occlusion of aortic arch branches
- Occlusion of carotid arteries
- Occlusion of the subclavian artery
- Takayasu's syndrome (absence of pulse)
- Chronic occlusion of mesenteric vessels (abdominal toad)
- Stenosis of the renal arteries
- Obliterating thrombangitis
- Raynaud's disease
- Orcoepididymitis
- Acute abdomen
- Acute pancreatitis
- Chronic pancreatitis
- Acute cholecystitis
- Panaritium
- Panaritium cutaneous
- Paronichy
- Panaritium subungual
- Panaritium tendinous
- Panaritium articular
- Panaritium bone
- Penetrating ulcer of the stomach and duodenum
- Peritonitis
- Peritonitis chronic
- Piopevneumotorax
- Pneumothorax spontaneous
- Postcholecystectomy syndrome
- Perforated ulcer
- Covered perforation
- Bedsore
- Prostatitis
- Wounds
- Fistulas of the rectum
- Stenosis of the outlet stomach
- Fracture of anus
- Urethritis
- Phimosis, paraphimosis
- Phlebothrombosis
- Occlusion of subclavian vein
- Phlegmon
- Furuncle
- Cholangitis
- Electric trauma
- Empyema of the pleura
- Congenital intestinal obstruction
- Atresia of the anus
- Congenital cholangiopathy of newborns
- Pylorostenosis
- Embryonic hernia (hernia of umbilical cord)
- Exstrophy of the bladder
- Dropsy of shells of testis and spermatic cord
- Surgical diseases of the chest
- Congenital diaphragmatic hernia
- Congenital cysts of the lungs
- Pneumothorax
- Tracheophishoprine fistula
- Mastitis of newborns
- Acute hematogenous osteomyelitis
- Peritonitis in newborns
- Acute paraproctitis
- Necrotic phlegmon of newborns
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