Comprehensive treatment of cardiac mucosa in 36 ca -

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Comprehensive treatment of cardiac mucosa in 36 cases of tear syndrome

Is: Check the wound within 24 hours of new blood spill in 21 cases, 48 hours, 8 cases of blood scab within 72 hours covered with a thin white coating of 7 cases. 16 cases were followed up after 3 months, no ulcer and scar endoscopy review. 2 cases of wound healing in patients undergoing endoscopy good. 3 Select the door to discuss gastric mucosal tear syndrome (Mallozy.weisssyndrome,[link widoczny dla zalogowanych], Mws) Department of intragastric pressure surge caused by vomiting, gastric cardia strong contraction of the cardia not open due to torn mucous membrane bleeding. Mws of upper gastrointestinal bleeding accounts for about 3% to 15% 【. Solid advocate endoscopy completed in 24h, to avoid misdiagnosis. The disease causes: ① severe nausea and vomiting caused by the sudden increase in intra-abdominal pressure,[link widoczny dla zalogowanych], Atkinson and other evidence in healthy adults can be increased intragastric pressure when vomiting to l20 ~ 160mmHg, the peak pressure up to 200mmHgJ. domestic scholars observation showed: when the intragastric pressure increased to 19-3 ~ 20.0kPa (100 ~ 150mmHg),[link widoczny dla zalogowanych], the cardia mucosa tear can occur. ② Second, near the cardia mucosa structure is relatively weak, muscularis mucosa stretch of the poor, lack of support around the organization, under the impact of high pressure in the stomach and thus prone to tearing. cardia mucosa in the longitudinal tear the level of tension is needed to tear half of the 【4】 So much for the longitudinal mucosal tear linear or spindle. hemorrhage with laceration length and tear parts not relevant reports. cardia mucosa after tearing, mild person, lacerations common in the 0.5 ~ 1cm, and one at the more common, the acid, self-healing after 24 hours of fasting. For the bleeding obvious, less than 500ml, endoscopic treatment of common bleeding with microwave, laser, electrical coagulation,[link widoczny dla zalogowanych], wound spray adrenaline of Traditional Chinese Medicine treatment, the effect is positive. Yang Yi, such as early use of endoscopic microwave therapy l5】 Ben gastric mucosal tear syndrome is effective for the method is simple, proper use can avoid surgery. Bataller16l so, the report of local injection sclerotherapy with satisfactory hemostasis effect. But Bataller report 5% to 35% of patients need surgical treatment, this group of patients accounted for 6.6% of surgical patients, consistent with the reported literature. I believe that when the crack is longer than the wound 1.5cm, 24 小时 bleeding volume 800ml, and there taking non-steroidal drugs or medical endoscopic therapy, bleeding effects are not satisfied, it is timely surgery. the group 2 cases of surgical patients,[link widoczny dla zalogowanych], intraoperative exploration, see the wound cleft longer than 1.5cm, deep to the submucosa, Bo mobility bleeding. the mucosa and submucosa simple suture hemostasis; after effect, were successfully discharged. ⑦

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