[A discussion on acute simple appendicitis].
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Biomedical subjects
Publications and source records attributed to V D Bratus'.
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It was thought formerly that gastrointestinal hemorrhage is an integral part of gastric ulcer. At present this is not a regularity, occurs only in some patients with ulcer disease and in other kinds of pathology (liver cirrhosis, dilated esophageal veins and oth.). Surgical treatment during hemorrhage is connected with risk for the patients. We recommend temporary tamponade of the bleeding blood vessels, improvement of the general condition of the patient and then transferring the patient to a surgical department for determination of further tactics.
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On the basis of the analysis of 1023 clinical observations of hemorrhagic shock in acute gastric hemorrhage, the modern notions about the mechanisms of its development, peculiarities of the clinical course, depending on nature and volume of blood loss are stated. A scheme for intensive anti-shock therapy has been developed. The lethality after 1892 emergency operations was 3%, and in ulcer with hemorrhagic shock after 547 operations--9.3%.
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The Mallory-Weiss syndrome was observed in 4.5% of 4154 patients with gastrointestinal bleedings. In 113 patients with arrest of the bleeding the conservative drug therapy was performed, in patients with continuing bleedings (76 patients)-endoscopic diathermic coagulation was fulfilled with complete and perfect hemostasis without complications and lethal outcomes.
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The work has shown that concentrating the patients with acute gastro-intestinal bleedings at surgical hospitals having qualified surgeons, auxiliary services and necessary equipment can give a considerable improvement of differential diagnosis of the source of bleeding in the acute period, higher surgical activity in the ulcer on cancer nature of the bleeding, better results of both the operative and conservative methods of treatment.
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