Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers

Aim of investigation. To estimate necessity and potentials of dynamic esophagogastroduodenoscopies (EGDS) at successful primary hemostasis in patients with high risk of relapse of bleeding.Material and methods. Retrospective analysis of case records of 332 patients hospitalized for bleeding from chr...

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Main Authors: V. A. Stupin, S. V. Siluyanov, M. B. Sokhikyan, R. Yu. Tronin, R. Sh. Sardarov
Format: Article
Language:Russian
Published: Gastro LLC 2011-12-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/1470
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author V. A. Stupin
S. V. Siluyanov
M. B. Sokhikyan
R. Yu. Tronin
R. Sh. Sardarov
author_facet V. A. Stupin
S. V. Siluyanov
M. B. Sokhikyan
R. Yu. Tronin
R. Sh. Sardarov
author_sort V. A. Stupin
collection DOAJ
description Aim of investigation. To estimate necessity and potentials of dynamic esophagogastroduodenoscopies (EGDS) at successful primary hemostasis in patients with high risk of relapse of bleeding.Material and methods. Retrospective analysis of case records of 332 patients hospitalized for bleeding from chronic stomach and duodenum ulcers was carried out. Evaluation of results in 122 patients after repeated EGDSs was carried out with account to causes of inefficiency of previous investigations.Results. Repeated gastroscopies were caused by: relapse of bleeding – in 21 (17,2%) patient, of them in 81% of cases it developed within first 3 days after primary examination, non-informative initial EGDS – in 12 (9,8%), control gastroscopy in dynamics – in 89 (73%). Frequently the bleeding relapses in early terms educed due to ineffective endoscopic hemostasis at active bleedings or absence of prophylaxis at high risk of relapse (Forrest IIA-IIB) at previous gastroscopy. Control gastroscopies in 55 (62%) patients were performed in 1 day after primary investigation that allowed in 6 patients with high risk of bleeding relapse to reveal active recurrent bleeding before its clinical manifestation. In 39 (32 %) patients further required repeated gastroscopies, 17 (14%) patients were urgently operated in relation to ineffective endoscopic hemostasis or high risk of bleeding relapse at repeated EGDSs. Of all patients 19 died (15,6%), of them 5 – in postoperative period.Conclusions. Principal causes of repeated gastroscopies were relapses of bleeding in early period after primary hemostasis and ineffective investigations. Relapses of ulcerative bleeding develop mostly in the first 3 days after primary hemostasis. At clinically significant relapses repeated gastroscopy with preventive actions is proven in patients with high operational risk on concomitant diseases (4–5 points by ASA scale). Repeated endoscopic investigations have no significant effect on clinical results of treatment of ulcerative bleedings, frequency of relapses, operative activity, mortality.
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spelling doaj-art-1eb3cf4b27174806ad84631e2ad02d822025-02-10T16:14:31ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732011-12-012161218994Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcersV. A. StupinS. V. SiluyanovM. B. SokhikyanR. Yu. TroninR. Sh. SardarovAim of investigation. To estimate necessity and potentials of dynamic esophagogastroduodenoscopies (EGDS) at successful primary hemostasis in patients with high risk of relapse of bleeding.Material and methods. Retrospective analysis of case records of 332 patients hospitalized for bleeding from chronic stomach and duodenum ulcers was carried out. Evaluation of results in 122 patients after repeated EGDSs was carried out with account to causes of inefficiency of previous investigations.Results. Repeated gastroscopies were caused by: relapse of bleeding – in 21 (17,2%) patient, of them in 81% of cases it developed within first 3 days after primary examination, non-informative initial EGDS – in 12 (9,8%), control gastroscopy in dynamics – in 89 (73%). Frequently the bleeding relapses in early terms educed due to ineffective endoscopic hemostasis at active bleedings or absence of prophylaxis at high risk of relapse (Forrest IIA-IIB) at previous gastroscopy. Control gastroscopies in 55 (62%) patients were performed in 1 day after primary investigation that allowed in 6 patients with high risk of bleeding relapse to reveal active recurrent bleeding before its clinical manifestation. In 39 (32 %) patients further required repeated gastroscopies, 17 (14%) patients were urgently operated in relation to ineffective endoscopic hemostasis or high risk of bleeding relapse at repeated EGDSs. Of all patients 19 died (15,6%), of them 5 – in postoperative period.Conclusions. Principal causes of repeated gastroscopies were relapses of bleeding in early period after primary hemostasis and ineffective investigations. Relapses of ulcerative bleeding develop mostly in the first 3 days after primary hemostasis. At clinically significant relapses repeated gastroscopy with preventive actions is proven in patients with high operational risk on concomitant diseases (4–5 points by ASA scale). Repeated endoscopic investigations have no significant effect on clinical results of treatment of ulcerative bleedings, frequency of relapses, operative activity, mortality.https://www.gastro-j.ru/jour/article/view/1470ulcerative gastroduodenal bleedingrisk of bleeding relapsedynamic gastroscopies
spellingShingle V. A. Stupin
S. V. Siluyanov
M. B. Sokhikyan
R. Yu. Tronin
R. Sh. Sardarov
Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
ulcerative gastroduodenal bleeding
risk of bleeding relapse
dynamic gastroscopies
title Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
title_full Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
title_fullStr Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
title_full_unstemmed Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
title_short Repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
title_sort repeated gastroscopies at impendent relapse of bleeding from gastroduodenal ulcers
topic ulcerative gastroduodenal bleeding
risk of bleeding relapse
dynamic gastroscopies
url https://www.gastro-j.ru/jour/article/view/1470
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AT svsiluyanov repeatedgastroscopiesatimpendentrelapseofbleedingfromgastroduodenalulcers
AT mbsokhikyan repeatedgastroscopiesatimpendentrelapseofbleedingfromgastroduodenalulcers
AT ryutronin repeatedgastroscopiesatimpendentrelapseofbleedingfromgastroduodenalulcers
AT rshsardarov repeatedgastroscopiesatimpendentrelapseofbleedingfromgastroduodenalulcers