GASTRODUODENAL ULCERAL BLEEDINGS, DIAGNOSIS AND RISK FACTORS FOR REDUCTION. LITERATURE REVIEW.

Abstract

Introduction: Ulcerative gastroduodenal bleeding (UGDH) is a serious complication of peptic ulcer of the stomach and duodenum, remaining to this day an urgent problem in urgent surgery. The most common causes of acute upper gastrointestinal bleeding (UGIH) are gastroduodenal bleeding of non-variceal origin. YAGDK is observed with greater frequency in men and older people; the prevalence of the complication is 48 - 160 people per 100,000 population. Despite the achievements of medical science and the success of surgical practice, the upward trend in the frequency of ulcerative hyperplasia remains. Thus, the number of patients with ulcerative gastroduodenal bleeding in the period from 2005 to 2015 increased by 1.5 times. Aim: review the literature on endoscopic treatment of gastroduodenal bleeding. Search strategy: The literature search was carried out in search engines: Pubmed, Google Academy, elibrary.ru, as well as manually. The search depth of Pubmed, Google Scholar, elibrary.ru, and also “manually” was not limited. The following filters were used: full text, humans. Criteria for inclusion of publications in the review: publications that are in full text access, in Russian and English, bearing statistically verified conclusions. Exclusion criteria: duplicate data, abstracts of reports, newspaper publications, personal communications. Results: There are methods for determining the likelihood of rebleeding, including both direct and indirect assessments of blood flow in the ulcer bed. They are based on the use of endoscopic Doppler, endoscopic ultrasound diagnostics, local thermometry of ulcers, impedance measurements of the mucous membrane of the stomach and duodenum. However, their use in general clinical practice is limited. Ulcer size, volume of blood lost, and hemoglobin level have been found to be important indicators for predicting rebleeding. Even without taking into account their combined effect, these parameters have a confidence of about 90% in predicting recurrent bleeding. Conclusions: In practice, in emergency hospital settings, the use of complex instrumental methods and statistical calculations is difficult due to limited time and availability. This is especially true at night. Therefore, the importance of developing and improving simple, easily applicable, and effective criteria for predicting recurrent upper gastrointestinal bleeding remains high.