[Gastrointestinal hemorrhage].

Minerva Chir

Chirurgia II Divisione, Ospedale Civile, Asti.

Published: March 1998

Acute digestive system haemorrhage is a recurrent cause of hospitalization. As to the upper segment of the digestive system, ulcerous peptic disease is often the cause of this pathology, above all in Western Countries. As to the lower segment, colic diverticula and angiodysplasy represent the most common cause. Bleeding usually clears up spontaneously or with hemodynamic pharmacological help. In some cases, the situation does not improve because of bleeding persistence, so more complex diagnostic and therapeutic techniques are necessary. Instrumental diagnostics is based on endoscopy (once with flexible optical fibre instruments, now with videoendoscopy) whose diagnostic effectiveness is inversely proportional to the latency since the haemorrhagic occurrence. Success is evident in 90-95% of the cases within the first twelve hours. Mesenteric angiography and scintigraphy with marked erythrocytes can solve difficult diagnosis and topographic location on some serious occasions. In every case the risk of complication and death is closely related to the haemorrhagic consistency, the flow of the bleeding, the basic disease, the age and the presence of chronic diseases. The authors examine a personal survey taken from the hospitalization in their own ward during a period of a year.

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