Modern methods of diagnosis and treatment of acute gastrointestinal bleeding of various etiology

Aim. Analysis of the treatment results in patients with gastrointestinal bleeding with the use of endoscopic and surgical methods of hemostasis.

Methods. Analysis of the treatment results in 421 patients with acute gastrointestinal bleeding from the urgent surgical department of City Clinical Hospital №7 of Kazan was conducted.

Results. Endoscopic methods of hemostasis in bleeding from the upper gastrointestinal tract (argon plasma coagulation, combined prolonged infiltration hemostasis with the use of 6% solution of polyglucin with mafusol, irrigation with the solution «Hemolab», ligation of the esophageal veins and Danis stent implantation) were applied to 404 patients. All patients simultaneously received conservative treatment. When using the methods of endoscopic hemostasis mentioned above in patients with bleeding from upper gastrointestinal tract the efficiency was achieved in 87.9% of cases. It was the highest when using combined endoscopic methods. Recurrent acute bleeding was diagnosed in 30 (7.1%) cases. Majority of the patients with recurrent bleeding suffered from gastric ulcer and/or duodenal ulcer (21 patients). In all 30 patients with recurrent bleeding surgical intervention with the author’s technique was performed.

Conclusion. The efficacy of endoscopic methods of hemostasis in bleeding from the upper gastrointestinal tract, especially their combined use, was revealed; differentiated approach to the use of endoscopic and surgical techniques of hemostasis depending on the source of bleeding and its intensity is required.