Giorgio P, Lorusso D, Scotto F, Di Matteo G
Istituto di Ricovero e Cura a Carattere Scientifico, Specializzato in Gastroenterologia S. de Bellis, Castellana Grotte, Bari.
Minerva Dietol Gastroenterol. 1990 Oct-Dec;36(4):215-8.
The paper reports a series of 236 patients who underwent emergency esophagogastroduodenoscopy (EGDS) (within 48 hours of hospitalisation) due to hemorrhage of the upper digestive tract. A definitive diagnosis of the of bleeding was made in 233 (98.7%) cases. In 1.3% of cases, endoscopic tests proved negative. The most frequent cause of bleeding was duodenal ulcer, followed by esophageal varices. Hemorrhage was caused in only 46.2% of 80 cirrhotic patients by the rupture of esophageal varices, whereas in the remaining 53.8% of cases the source of hemorrhage was a lesion associated to esophageal varices. Surgery was necessary in 15 patients (6.4%). The death rate within 30 days was 5.5%. In conclusion, emergency EGDS performed within 24 hours of hospitalisation is the most precise diagnostic technique for upper gastrointestinal bleeding.
该论文报告了一系列236例因上消化道出血而接受急诊食管胃十二指肠镜检查(EGDS)(住院48小时内)的患者。233例(98.7%)病例明确诊断出出血原因。1.3%的病例内镜检查结果为阴性。最常见的出血原因是十二指肠溃疡,其次是食管静脉曲张。80例肝硬化患者中,仅46.2%的出血是由食管静脉曲张破裂引起的,而其余53.8%的病例出血源是与食管静脉曲张相关的病变。15例患者(6.4%)需要进行手术。30天内的死亡率为5.5%。总之,住院24小时内进行的急诊EGDS是上消化道出血最精确的诊断技术。