Medical treatment of digestive bleeding
Tratamiento médico de las hemorragias digestivas
Resumen:
Patients suffering from digestive hemorrhage should be cared for by a medico-surgical team composed ofgastroenterologist, surgeon and radiologist. After reinstatement of volemia, by venous catheterism, initial diagnostic exploration should be performed at once so as to determine what is bleeding. In hemorrhages of esophago-gastro-duodenal originpan-endoscopy should be performed at once, complemented if necessary by selective arteriography and conventionál gastro-duodenal examination. lf urgency surgery is not indicated, a schedule for medical treatment should be established, consisting of hourlycold milk diet, non-absorbable antiacids and drugs. Clinícal, nursing and laboratory control are important during this _period. Grave low digestive hemorrhages should first receive medica! treatment. After urgency endoscopy for the purpose of diagnosis, specific medica!treatment should be set in accordance with etiology. Finally case material, consisting of 585 digestive hemorrhages is described; 469 were not operated and evolution was good in 60 % of cases.
La atención del enfermo con una hemorragia digestiva debe ser efectuada por un equipo medicoquirúrgicointegrado por gastroenterólogo, cirujano y radiólogo. Luego de la reposición volémica por cateterismo venoso, debe efectuarse inmediatamente la exploración diagnóstica inicial para determinar inequívocamente qué sangra. Para ello en las hemorragias de origen esofagogastroduodenaldebe hacerse de entrada una panendoscopía, complementada luego si fuera necesario, con arteriografía selectiva y gastroduodeno convencional. Si no surge la necesidad de intervención quirúrgica de urgencia se programará el tratamiento médico en basea dieta láctea fria horaria, antiácidos inadsorbibles, y fármacos de acuerdo al caso. Se señala la importanciadel control clínico, de enfermería y de laboratorio durante el tratamiento médico. Las hemorragias digestivas bajas graves son en primerainstancia siempre de tratamiento médico. Luego de endoscopia de urgencia para establecer el diagnósticose indicará el tratamiento médico especifico de acuerdo a la etiología. Se presentan finalmente los resultados del tratamiento de 585 hemorragias digestivas, de las cuales 469 no fueron operadas, con 60 % de evolución buena.
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hemorragia digestiva tratamiento digestive hemorrhage treatment |
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Español | |
Sociedad de Cirugía del Uruguay | |
Revista Cirugía del Uruguay | |
https://revista.scu.org.uy/index.php/cir_urug/article/view/2661 | |
Acceso abierto |
Sumario: | Patients suffering from digestive hemorrhage should be cared for by a medico-surgical team composed ofgastroenterologist, surgeon and radiologist. After reinstatement of volemia, by venous catheterism, initial diagnostic exploration should be performed at once so as to determine what is bleeding. In hemorrhages of esophago-gastro-duodenal originpan-endoscopy should be performed at once, complemented if necessary by selective arteriography and conventionál gastro-duodenal examination. lf urgency surgery is not indicated, a schedule for medical treatment should be established, consisting of hourlycold milk diet, non-absorbable antiacids and drugs. Clinícal, nursing and laboratory control are important during this _period. Grave low digestive hemorrhages should first receive medica! treatment. After urgency endoscopy for the purpose of diagnosis, specific medica!treatment should be set in accordance with etiology. Finally case material, consisting of 585 digestive hemorrhages is described; 469 were not operated and evolution was good in 60 % of cases. |
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