| Abstrakt: |
The paper is based on the analysis of clinical, X-ray, and morphological studies in 74 patients with massive gastrointestinal hemorrhage who were treated at the hospitals of the N.V. Sklifosofsky Research Institute of Emergency Care, in 1991-1994. Among the examinees, there were 28 with medio-gastric ulcer and 44 with parapyloric ulcers. In 2 patients bleeding occurred with the anastomosis ulcers of the stomach operated on. The paper presents the specific features of X-ray studies of patients with bleeding gastroduodenal ulcers. X-ray studies should be twice performed in these patients. The first study is conducted if gastroscopic findings are unclear, the repeated one is carried out while assessing changes in disease regression. The emergency gastroscopic and subsequent X-ray studies have demonstrated that acute ulcers may be at various sites and multiple. X-ray diagnosis of bleeding ulcers is determined by their sites and the nature of an ulcerous process. The X-ray diagnosis of chronic callous gastric ulcers accompanied by hemorrhage was based on the detection of two direct symptoms of a "niche" on the gastric outlines and configuration and an inflammatory mound on the gastric outline and configuration. That of chronic bleeding ulcers of the duodenal bulb is based not only on searches for the basic symptom of peptic ulcer -"niche", but other signs of the disease-the deformed organ, and the magnitude of a periprocess. Gastroduodenoscopy is applied not only for the primary diagnosis of a hemorrhagic source, but a therapeutical technique. However, the use of endoscopy alone in patients with gastroduodenal hemorrhage did not give a comprehensive idea of the magnitude of ulcerous changes, organ-specific deformity, and a periprocess. |
