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Endoscopia

versão On-line ISSN 2444-6483versão impressa ISSN 0188-9893

Resumo

RIVERA-FLORES, Andy Gabriel et al. Experiencia acerca de la etiología, incidencia de la hemorragia digestiva alta variceal y su tratamiento en el Hospital General Dr. Manuel Gea González. Endoscopia [online]. 2019, vol.31, suppl.2, pp.528-531.  Epub 14-Fev-2022. ISSN 2444-6483.  https://doi.org/10.24875/end.m19000167.

Introduction:

High variceal hemorrhage (HAV) in the cirrhotic patient is the most direct complication of portal hypertension and leads to high morbidity and mortality, however recent data suggest an improvement in these indicators when instituting advances in prophylaxis and treatment, however clinicians have poor adherence to the management guidelines of patients withacute variceal bleeding and this increases the morbidity and mortality of these patients. There are few epidemiological studies, however in several studies in Mexico consider variceal hemorrhage as the most frequent cause of high digestive bleeding.

Objective:

To describe the etiology, incidence and success rate in endoscopic treatment in patients with HAV.

Material and methods:

It is a retrospective descriptive observational study in patient who were asked for their endoscopic study due to high digestive bleeding. The study was conducted in the period from December 2017 to March 2019 in the Gastrointestinal endoscopy service of the Dr. Manuel Gea González General Hospital. Sociodemographic data were taken. 4095 endoscopies were performed, of which 2661 were due to high digestive bleeding and at the time of the study only 1.197 Panedoscopies were by HA V representing 45% of the studies.

Results:

The average age was 45 years (SD 13.07 2). The endoscopic diagnosis was very similar with 40% for small esophageal varices of BAVENO VI and esophageal varices with 40% each; followed with 15% for esophageal varices with gastric varices and only 5% with gastric varices. Patients with small esophageal varices of BAVENO were linked by 20% because they had poor prognosis data; large gastric varices were ligated in 80% of the cases, 1% argon plasma and 10% with sclerotherapy; GOV 1 gastric varices 80% were sclerosed withcyanoacrylate, 20% were ligated; GOV, VGA1, VGA2 were all used Cyanoacrylate, with a success rate in the treatment 90-95%.

Conclusions:

In our population, HV represents 4 5% of cases of high digestive bleeding. The frequency between small and large esophageal varices was similar with 40% each. The success rate was 90-95%, similar to the literature in India but lower in developed countries.

Palavras-chave : Variceal hemorrhage; Etiology; Endoscopic treatment.

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