GASTROİNTESTİNAL SİSTEM KANAMALARI. Doç.Dr.Tamer AKÇA. http://hastaneciyiz.blogspot.com. Sağlık. Slayt. Arşivi:. Treitz L igamanı. Üst gastrointestinal sistem kanamaları Alt gastrointestinal sistem kanamaları. Tanımlar . Gizli (okkült)kanama; anemi/gaytada gizli kan
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Özofajit ,gastrit, stres ülseri, duodenal ülser, stomal ülser, rejyonel enterit, kolitis ülseroz, divertikülit
Hiatus hernisi, Mallory-Weiss sendromu, divertikülozis
Adenokanser, polip, leiomiyom
Özofagus varisleri, hemanjiyoma, anjiyodisplazi, hemoroid, aortaintestinal fistül
Üremi, kolajen hastalıklar
Hemofili, Von Willebrand hastalığı
Duplikasyonlar, Meckel divertikülü
Epistaksis, hemoptisi, orofaringeal kaviteden kaynaklanan kanama
A 74 year-old male presented with a history of passing large amounts of bright red blood per rectum. He had one previous episode four years before that required hospitalization and stopped spontaneously. No source of bleeding was documentedon that admission. Statistically, the majority (60%) of GI bleeds are from an upper GI source
Oarsmen at Chatou 1879 (200 Kb); Oil on canvas, 81.3 x 100.3 cm (32 x 39 1/2"); National Gallery of Art, Washington, DC
The gastroduodenal artery lies between the duodenum and head of the pancreas and is usually a branch of the common hepatic artery.
Massive upper GI bleeds most commonly result from erosion into the gastroduodenal artery by a posterior penetrating duodenal ulcer (narrative on portal hypertension and bleeding esophageal varices to follow at a future date). Initial endoscopic control of a bleeding ulcer is usually achieved with bipolar coagulation and/or injection of epinephrine. However, if a vessel is visible in the base of the ulcer, the chance of re-bleed is greater than 50%.
Control of bleeding is obtained with figure of eight non-absorbable (eg. silk) stitches beneath the vessel on either side of the bleeding point. Care must be taken not to go so deep as to endanger the bile duct.
Le déjeuner des canotiers
1881 (220 Kb); "The Luncheon of the Boating Party";
(60 yaşın altında en sık masif kanama sebebi)
(60 yaşın altında en sık sebep)
(60 yaşın üzerinde en sık masif kanama sebebi)
(Tekrarlayan alt GIS kanamalarının en sık sebebi)
(Çocukluk çağında en sık sebep)
Orta Dereceli Subakut veya Kronik Kanama
Enflamatuvar Barsak Hastalıkları
(60 yaşın üzerinde en sık sebep)
Soliter Rektal Ülser
Diverticula develop through the muscular weakness created by vessels penetrating the muscular wall of the colon.
Colonic diverticula are false diverticula (only part of the wall – the mucosa and submucosa protrude).
When stool becomes dessicated within the diverticulum and forms a fecolith, it can press on the adjacent vessel and erode into it. The natural history of diverticular bleeding is that most episodes stop spontaneously and multiple episodes are common. It is important to document the source early by bleeding scan in case interventional radiology or surgery becomes necessary. Both diverticular bleeding and another source of colonic bleeding – ateriovenous malformation – are statistically more common in the right side of the colon.
There was an immediate, dramatic blush in the ascending colon indicating a rapid, ongoing bleed
The patient was taken to the ICU for resusciation. The bleeding stopped after initial transfusion of two units. Although there was no blood returned on NG aspirate, upper endoscopy was performed first. The examination showed no bleeding site in stomach or duodenum. Flexible sigmoidoscopy revealed dark blood in the rectum with no active source of
Lady Sewing 1879 (60 Kb); Art Institute of Chicago