Recidivas de hemorragia digestiva alta en el Hospital Universitario de Guayaquil entre 2014-2015
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Se define a la HDA como un sangrado que tiene su origen en algún punto del tubo digestivo desde la boca, bucofaringe, esófago estómago y duodeno hasta el ligamento de Treitz. Las causas de la hemorragia digestiva son numerosas pero, generalmente, la hemorragia es secundaria a una enfermedad sistémica. Las etiologías son diversas: la úlcera gastroduodenal, las lesiones agudas de las mucosas gástrica o duodenal y la ruptura de várices esofágicas son las etiologías más frecuentemente descritas. Desde el punto de vista de su gravedad, la hemorragia gastrointestinal puede abarcar desde la forma masiva aguda hasta las pérdidas sanguíneas crónicas e intermitentes; pudiendo la hemorragia digestiva alta aguda manifestarse de tres maneras: hematemesis, melena y hematoquezia; estas formas de presentación dependen de la magnitud del sangrado, Se realizó la determinación de porcentaje de recidivas de casos de hemorragia digestiva alta atendidas en el Hospital Universitario de Guayaquil entre 2014- 2015, por lo cual se elabora un estudio de tipo retrospectivo, descriptivo no experimental . Se analizaron todos los pacientes con diagnóstico de Hemorragia digestiva alta, durante el periodo comprendido entre el 1 de enero del 2014 al 31 de diciembre del 2015, atendidas en el área de consulta externa de Gastroenterología del Hospital Universitario de Guayaquil. En los resultados se estableció una recidiva del 16.39% del pacientes del universo de muestra (305 pacientes), el intervalo de edad que volvió al hospital por el mismo cuadro corresponde a pacientes entre 43-55 y 67-79 años con igual porcentaje 26% (13-13 pacientes). Dentro de los Factores de Riesgo asociados el principal fue la ingesta de aines con un 55% (11 pacientes). Las principales Manifestaciones Clínicas fueron la anemia con un 37% (31 pacientes), seguido por sintomatología de shock con un 33% (28 pacientes), hematemesis con un 18% (15 pacientes) y finalmente melena con 12% (10 pacientes).
Upper gastrointestinal bleeding is defined as bleeding derived from a source proximal to the ligament of Treitz (from the esophagus, stomach, or duodenum). There are numerous causes of upper gastrointestinal bleeding but generally it is secondary to a systemic disease. There are diverse etiologies: peptic ulcers, gastric erosions, esophageal varices´ rupture. According to its severity gastrointestinal bleeding could be massive and a potentially life-threatening abdominal emergency or could simply appear as a chronic or intermittent blood lost. Blood may be observed in vomit (hematemesis),in altered form in the stool (melena) or Hematochezia. The percentage of upper gastrointestinal bleeding recurrence was determined in all the cases seen in the Hospital Universitario de Guayaquil consult between the years 2014-2015. All the patients with upper gastrointestinal diagnose during the time between January the 1st, 2014 to December the 31, 2015 were analyzed, which leaded to a retrospective, nonexperimental and descriptive study. In the results was establish a 16.39% recurrence, in the 305 patients´s universe .The most affected patients were in the 43-55 and 67-79 age range, representing the 26% for both rages (1313patients). In risk factors the most significant was the nonsteroidal antiinflammatory drugs (NSAIDs) ingestion with a 55% (11 patients). The main signs and symptoms of acute upper GI bleeding were anemia with a 37% (31 patients), follow by shock symptoms with a 33% (28 patients), hematemesis with a 18% (15 patients) and finally melena with a 12% (10 patients).
Upper gastrointestinal bleeding is defined as bleeding derived from a source proximal to the ligament of Treitz (from the esophagus, stomach, or duodenum). There are numerous causes of upper gastrointestinal bleeding but generally it is secondary to a systemic disease. There are diverse etiologies: peptic ulcers, gastric erosions, esophageal varices´ rupture. According to its severity gastrointestinal bleeding could be massive and a potentially life-threatening abdominal emergency or could simply appear as a chronic or intermittent blood lost. Blood may be observed in vomit (hematemesis),in altered form in the stool (melena) or Hematochezia. The percentage of upper gastrointestinal bleeding recurrence was determined in all the cases seen in the Hospital Universitario de Guayaquil consult between the years 2014-2015. All the patients with upper gastrointestinal diagnose during the time between January the 1st, 2014 to December the 31, 2015 were analyzed, which leaded to a retrospective, nonexperimental and descriptive study. In the results was establish a 16.39% recurrence, in the 305 patients´s universe .The most affected patients were in the 43-55 and 67-79 age range, representing the 26% for both rages (1313patients). In risk factors the most significant was the nonsteroidal antiinflammatory drugs (NSAIDs) ingestion with a 55% (11 patients). The main signs and symptoms of acute upper GI bleeding were anemia with a 37% (31 patients), follow by shock symptoms with a 33% (28 patients), hematemesis with a 18% (15 patients) and finally melena with a 12% (10 patients).
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RECIDIVA, HEMORRAGIA GASTROINTESTINAL, EPIDEMIOLOGIA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL UNIVERSITARIO DE GUAYAQUIL, CANTON GUAYAQUIL, ECUADOR, COMPLICACIONES, TRATAMIENTO