Collaguazo P M, Andreollo N A, Lopes L R, dos Santos J O, Yamanaka A, Magalhães A F, Brandalise N A
GASTROCENTRO do Hospital das Clínicas da Universidade Estadual de Campinas-UNICAMP, SP.
Arq Gastroenterol. 1993 Oct-Dec;30(4):88-93.
During the period from August 1st, 1990 to June 15, 1992, 117 patients with portal hypertension and upper gastrointestinal bleeding were examined at the "GASTROCENTRO"--State University of Campinas--UNICAMP, Campinas, SP, Brazil few hours after hospital admission. The objectives were to study the association of gastroduodenal acute lesions and esophageal varices. The predominant ages were thirties and sixties years (83.76%), being 70.08% of males. The hematemesis occurred in 94.02% of the cases. The etiologies of the bleeding were: esophageal varices, 47.87%; gastroduodenal acute mucosal lesions, 34.19%; gastric varices, 9.4%; gastric ulcers, 5.98% and duodenal ulcers, 2.56%. The authors concluded that exists a significant association of acute gastroduodenal lesions and esophageal varices causing upper gastrointestinal bleeding. It is essential to examine early and in detail the gastroduodenal mucosa during upper digestive endoscopy in the patient with portal hypertension and esophageal varices to diagnose the etiology of the bleeding. It is advisable to perform endoscopic examination twice a year when the dyspeptic symptoms are constant, with previous treatment for gastroduodenal acute mucosal lesions or peptic ulcers, and annual in the others.
1990年8月1日至1992年6月15日期间，117例门静脉高压症合并上消化道出血患者在巴西圣保罗州坎皮纳斯市坎皮纳斯州立大学“胃肠中心”入院后数小时接受了检查。目的是研究胃十二指肠急性病变与食管静脉曲张的关联。主要年龄为三十多岁和六十多岁（83.76%），男性占70.08%。94.02%的病例出现呕血。出血病因如下：食管静脉曲张占47.87%；胃十二指肠急性黏膜病变占34.19%；胃静脉曲张占9.4%；胃溃疡占5.98%；十二指肠溃疡占2.56%。作者得出结论，急性胃十二指肠病变与食管静脉曲张之间存在显著关联，可导致上消化道出血。对于门静脉高压症合并食管静脉曲张的患者，在上消化道内镜检查时尽早并详细检查胃十二指肠黏膜以诊断出血病因至关重要。当消化不良症状持续存在、既往有胃十二指肠急性黏膜病变或消化性溃疡治疗史时，建议每年进行两次内镜检查，其他情况每年进行一次。
