medbioМедико-биологические проблемы жизнедеятельностиMedical and Biological Problems of Life Activity2074-2088Республиканский научно-практический центр радиационной медицины и экологии человекаmedbio-281Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEЛечение многократно рецидивирующего кровотечения из варикозно расширенных вен пищевода и желудкаConsecutive approach in treatment of resistant bleeding from esophageal varicesМогилевецЭ. В.MahiliavetsE. V.noemail@neicon.ruВасильчукЛ. Ф.VasilchukL. F.noemail@neicon.ruУО «Гродненский государственный медицинский университет»Russian FederationГродненская университетская клиникаRussian Federation20200203202301123134Copyright © Могилевец Э.В., Васильчук Л.Ф., 20232023Могилевец Э.В., Васильчук Л.Ф.Mahiliavets E.V., Vasilchuk L.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medbio.ejournal.by/jour/article/view/281

Профилактика развития варикозного расширения вен пищевода и желудка и его прогрессирования, предотвращение первого эпизода кровотечения из них, остановка острого кровотечения, а также профилактика повторных эпизодов кровотечений являются основными направлениями стратегии лечения пациентов с портальной гипертензией. В статье приведен анализ результатов выполнения в УЗ «Гродненская областная клиническая больница» в октябре 2018 года пациенту 56 лет с циррозом печени смешанной этиологии (вирусный гепатит В и С плюс алкогольной этиологии), класс В по Child-Pugh, открытой эзофагогастральной деваскуляризации со степлерной транссекцией пищевода с последующим выполнением эндоскопического гемостаза и трансъюгулярного портосистемного шунтирования по поводу многократно рецидивирующего кровотечения из ВРВП, а также краткий обзор библиографических источников по теме. Применение последовательного подхода в лечении многократно рецидивирующего кровотечения из ВРВП способствовало достижению стойкого гемостаза и отсутствию рецидивов кровотечений из ВРВП в послеоперационном периоде. Срок наблюдения после операции составил 8 месяцев, в течение которого рецидивов кровотечения отмечено не было.

Prevention of the development of esophageal and gastric varices and its progression, prevention of the first episode of bleeding, hemostasis in acute bleeding, as well as the prevention of repeated episodes of bleeding are the main directions of the treatment strategy in patients with portal hypertension.Analysis of the results of open esophagogastric devascularization with esophageal transection followed by endoscopic hemostasis and transjugular portosystemic shunting for persistently recurrent bleeding from esophageal varices.Open esophagogastric devascularization with esophageal transection followed by endoscopic hemostasis and transjugular portosystemic shunting for persistent recurrence of bleeding from esophageal varices were performed in Grodno Regional Clinical Hospital in October 2018. The operations were performed in a 56-year-old patient with liver cirrhosis of mixed etiology (viral hepatitis B and C plus alcohol), Child-Pugh class B, complicated by portal hypertension and recurrent bleeding from esophageal varices. The use of sequential approach in the treatment of repeatedly relapsing bleeding from esophageal varices contributed to the achievement of stable hemostasis and the absence of recurrence of bleeding from esophageal varices in the postoperative period. The follow-up period after surgery was 8 months; no recurrence of bleeding was noted during this period.The use of a combined sequential approach using open esophagogastric devascularization, endoscopic hemostasis and transjugular portosystemic shunting is effective in the treatment of repeatedly recurring episodes of hemorrhages from esophageal varices with the aim of finally stopping bleeding.

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The authors declare that there are no conflicts of interest present.