Thursday, January 20, 2011

Upper digestive bleeding - haematemesis

Upper digestive bleeding - haematemesis

    
* Introduction
    
* Pathogenesis and causes
    
* Signs and symptoms
    
* Diagnosis
    
* Treatment
Gastrointestinal Bleeding may originate anywhere from the mouth to the anus up. Clinical manifestations depending on the head bleeding. HDS-upper digestive hemorrhage refers to bleeding from digestive tract lower third of the esophagus, stomach and duodenum, regardless of etiology is externalized form. It is distinguished from lower gastrointestinal bleeding from the colon and rectum jejunoileon. Haematemesis is a varasatura in coffee grounds, which will differentiate itself from hemoptysis, vomiting in red wine, nosebleeds to swallowing, bilious vomiting, the drug-charcoal. The coffee grounds is dark blood in the form of coarse, like the look and color coffee grounds, because blood is partially digested by gastric juice. 80-90% of massive gastrointestinal bleeding from the esophagus, stomach, duodenum. The massive bleeding means a rapid loss of at least one liter of blood or a loss less massive, but occurs so leads to a brutal incite hypovolemia. Hypovolemia is a decrease in circulating volume resulting in an increase in the frequency pulse with low blood pressure and venous pressure in standing cebtrale. HDS causes are varied, which may enhance the clinical presentation, severity and therapeutic measures. From an etiological point of view may be non-cirrhotic or cirrhotic. Non-cirrhotic The most common include: esophageal ulcers, gastric, duodenal malignant or benign tumors. The cirrhotic esophageal varices are caused by the breakdown. HDS is not a systematic surgical indication. The indication for surgery depends on the severity of bleeding and endoscopic criteria laid is on evolution. In cases where bleeding does not stop medical therapy or in situations epetare it required surgery as last resort therapy. Treatment of non-bleeding cirrhotic status includes measures to combat shock and stop bleeding by coagulation. In the cirrhotic will use the condom hemostasis, endoscopic sclerosis are transjugular intrahepatic porto-systemic-TIPS and treating the disease.

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