Berenstein E G, Canievsky L O, Varsky C G, Fucile V, Lanza O, Passo R, Luis A, Colombato L O
Acta Gastroenterol Latinoam. 1982;12(4):351-9.
The experience in upper G.I. tract hemorrhage accumulated during the first 30 months in the Emergency Hemorrhage Unit at the Hospital Posadas is here reported over a total of 428 endoscopies, we found 518 lesions. Ninety one (21%) presented with active bleeding, and 317 (76%) were considered as the probable cause of the bleeding. In 37 cases (8.6%) the site of bleeding was detected, but the diagnosis wasn't done. The most frequent lesions were erosive gastritis (21.2%), gastric ulcer (20%), erosive duodenitis (12.6%), duodenal ulcer (12.15%) and esophageal varices (12.12%) the diagnosis was normal 14.7% of the cases. One hundred and sixty one patients were admitted to the hospital; on 143 (88.82%) patients the original diagnosis was confirmed but it was modified in 18 patients (11.18%) by surgery or repeated endoscopy. During the last 20 months of the period the accuracy diagnostic of the endoscopy increased 95%. When compared with the first 10 months (76%) this fact shows, the importance of the experience acquired by the endoscopist. Most of the patients received medical treatment with a mortality of 9.02% and 25 patients received surgical treatment with a mortality of 28%.
本文报告了波萨达斯医院急诊出血科在前30个月内积累的上消化道出血治疗经验,共进行了428次内窥镜检查,发现518处病变。91例(21%)有活动性出血,317例(76%)被认为是出血的可能原因。37例(8.6%)检测到出血部位,但未做出诊断。最常见的病变是糜烂性胃炎(21.2%)、胃溃疡(20%)、糜烂性十二指肠炎(12.6%)、十二指肠溃疡(12.15%)和食管静脉曲张(12.12%),14.7%的病例诊断正常。161名患者入院;143例(88.82%)患者的初步诊断得到证实,但18例(11.18%)患者经手术或重复内窥镜检查后诊断被修正。在此期间的最后20个月,内窥镜检查的诊断准确率提高到95%。与前10个月(76%)相比,这一事实表明了内镜医师积累经验的重要性。大多数患者接受药物治疗后死亡率为9.02%,25例患者接受手术治疗后死亡率为28%。