ABSTRACT
Hemorrhages from the upper part of the gastrointestinal tract pose serious surgical problems because of their rather elevated incidence, diverse etiopathogenesis, difficulties in diagnostic and therapeutic approach, and last but not least, owing to the high mortality rate. The incidence of patients with ulcers amount to 420 per 100,000 population, with those in advanced and old-age accounting for 15-40 per cent of the total number of affections. In this contingent ulcers run a course associated with a number of peculiarities conditioned by severe lesions, caused by an acute and prolonged blood loss, not infrequently associated with a serious co-morbidity typical of this age. For this reason periodic analysis of lethality due to hemorrhages in the upper segments of the gastrointestinal tract contribute greatly: to evaluate the factors affecting thanatogenesis of this particular disease. establish the dynamic pattern of mortality, and specify the therapeutic tactics influencing such dynamics.
Subject(s)
Gastrointestinal Hemorrhage/diagnosis , Aged , Aged, 80 and over , Bulgaria/epidemiology , Duodenal Ulcer/complications , Female , Gastrointestinal Hemorrhage/mortality , Gastrointestinal Hemorrhage/surgery , Hospital Mortality , Humans , Male , Middle Aged , Mortality/trends , Peptic Ulcer Hemorrhage/diagnosis , Peptic Ulcer Hemorrhage/mortality , Peptic Ulcer Hemorrhage/surgery , Postoperative Hemorrhage/diagnosis , Postoperative Hemorrhage/mortality , Postoperative Hemorrhage/surgery , Stomach Ulcer/complicationsABSTRACT
Bleeding gastroduodenal ulcers continue to be a common complication of diseases involving the upper segment of the gastrointestinal tract. In the last few years, with the introduction of fiber gastroscopy as a routine method of study, diagnosing of the underlying cause of hemorrhages is no longer a problem. A total of 959 emergency fibro-gastroduodenoscopies are performed.
Subject(s)
Duodenal Ulcer/complications , Duodenal Ulcer/therapy , Endoscopy, Gastrointestinal , Hemostasis, Endoscopic , Peptic Ulcer Hemorrhage/diagnosis , Peptic Ulcer Hemorrhage/therapy , Stomach Ulcer/complications , Stomach Ulcer/therapy , Acute Disease , Duodenal Ulcer/diagnosis , Emergencies , Fiber Optic Technology , Humans , Recurrence , Stomach Ulcer/diagnosisABSTRACT
The volvulus of the sigma is about 40% of all cases with colonic ileus. It is seen in men three times more frequently than in women and affects men in advanced and elderly age. Since 1985 in the Emergency Medical Aid Institute "N. Pirogov" an instrumental method is applied for the treatment of volvulus of the sigma, namely rectosigmoidal intubation under the control of the rectoscopic tube. In 15 cases the manipulation was successful, the volvulus was reversed and the patients were pulled out of the grave ileus condition. The clinical picture of the volvulus of the sigma is classic. The instrumental method can be applied only to patients without gata for an acute condition in the abdomen requiring immediate emergency operation. The instrumental treatment of the volvulus of the sigma prevents surgical interventions under unfavourable conditions for the patient. In elderly patients it may be a lifesaving manipulation.
