Hemoragiile digestive superioare rare
Cuvinte cheie:
„hemoragii digestive superioare rare”, „hemoragii rare cu origine din esofag, stomac, duoden”, „tratamentul hemoragiilor digestive superioare rare”Rezumat
Scopul articolului a fost de a analiza informația din sursele existente în literatură, cu privire la hemoragiile digestive superioare rare. Au fost studiate 62 publicații științifice ce conțin informații referitoare la epidemiologia, particularitățile tabloului clinic, de diagnostic instrumental și de tratament ale hemoragiilor digestive rare și cazuistice. În calitate de surse au fost utilizate publicații internaționale prin intermediul platformelor online Google Scholar și PubMed. Cuvintele cheie folosite la căutare au fost: «rare upper gastrointestinal bleeding», «rare bleeding with a point of origin in the esophagus, stomach, duodenum», «treatment of rare gastrointestinal bleeding». Au fost identificate 62 publicații științifice ce relevă informații actuale referitor la epidemiologia, particularitățile tabloului clinic, de diagnostic instrumental și de tratament ale hemoragiilor digestive rare și cazuistice. Deoarece frecvența hemoragiilor descrise în articol este mică, fiecare caz elucidat în literatura de specialitate reprezintă un punct de reper ce ne poate ajuta în stabilirea diagnosticului clinic, și a tacticii de tratament în cazuri similare. În hemoragiile din papila duodenală mare angiografia CT permite nu numai de a stabili diagnosticul corect, dar la necesitate efectuarea hemostazei prin embolizare vasculară. La pacienții cu hipertensiune portală, în cazul lipsei hemoragiei din varicele joncțiunii esogastrice, din ulcerul gastroduodenal este necesar de exclus hemoragia din varicele atipic duodenal sau intestinal. În cazurile cînd sursele frecvente ale hemoragiei digestive superioare lipsesc în timpul examenului endoscopic este necesar de efectuat o examinarea minuțioasă a mucoasei stomacului și duodenului, pentru a exclude leziunea Dieulafoy, ectopia vasculară gastrică antrală, fistula aortoduodenală, diverticolii gastroduodenali, tumorile stromale a stomacului.Colectarea datelor cu referire la compartimentul anamneza vieții pacientului ne va permite să stabilim prezența hemoragiei digestive determinată de telangiectazia hemoragică ereditară, sau de prezența dereglărilor de coagulare.
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