Bleeding Ulcer

Bleeding ulcer

      There are several mechanisms of bleeding ulcer:

• Ulcer bleeding by vascular (especially the gastroduodenal artery for ulcers of the posterior duodenal bulb, stomachic coronary artery for ulcers of the small gastric curvature. );
• Bleeding in mucous layer, or arteriolar bleeding.

      A bleeding ulcer can manifest clinically with hematemesis (vomiting blood) and / or melena (emission of black blood from the anus), anemia, acute collapse before exteriorization of rectal bleeding.

      The abundance of bleeding is assessed:

• Mainly on clinical criteria (signs of shock, syncope, thirst and rapid breathing) and review (coldness, fall in blood pressure and tachycardia);
• On the fall in hematocrit, which may be delayed;
• By evolution. The main criterion is changing the volume of blood transfused to maintain blood pressure and pulse within normal limits. A transfusion is necessary, when the hemoglobin falls below 7 to 9 g depending on the circumstances and terrain.

What happens during hospitalization in emergency bleeding ulcer?

      After evaluating the hemodynamic status, a large incision into the vein will be immediately implemented. Samples will be made. A nasogastric tube to double current is sometimes put in place to verify the presence of blood in the stomach and realize if necessary, a gastric lavage with iced water. Endoscopy is done urgently once the initial resuscitative measures have helped restore adequate hemodynamic status. This review will locate the bleeding and will clarify the cause and mechanism of injury. Surgery is indicated in cases of persistent bleeding or early relapse. The best treatment is excision, which also depends on the location of the ulcer