Severe bleeding of colonic origin
Serious colonic hemorrhages constitute an infrequent complication, but when they appear it is a grave emergency. They are somewhat more predominant in males, most frequently in aged persons. 69 % of the cases present intense acute anaemia; the remaining 31 % , modera te anaemia. It is easy to establ...
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| Format: | article |
| Language: | Spanish |
| Published: |
1971
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| Online Access: | https://revista.scu.org.uy/index.php/cir_urug/article/view/2165 |
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| _version_ | 1868890173728620544 |
|---|---|
| author | Mañana, Julio |
| author2 | Guicheff, Vladimir |
| author2_role | author |
| author_browse | Guicheff, Vladimir Mañana, Julio |
| author_facet | Mañana, Julio Guicheff, Vladimir |
| author_role | author |
| collection | Revista Cirugía del Uruguay |
| dc.creator.none.fl_str_mv | Mañana, Julio Guicheff, Vladimir |
| dc.date.none.fl_str_mv | 1971-02-10 |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | https://revista.scu.org.uy/index.php/cir_urug/article/view/2165 |
| dc.language.none.fl_str_mv | spa |
| dc.publisher.none.fl_str_mv | Sociedad de Cirugía del Uruguay |
| dc.relation.none.fl_str_mv | https://revista.scu.org.uy/index.php/cir_urug/article/view/2165/2087 |
| dc.rights.none.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | Cirugía del Uruguay; Vol. 41 No. 3 (1971): Cirugía del Uruguay; 250-258 Cirugía del Uruguay; Vol. 41 Núm. 3 (1971): Cirugía del Uruguay; 250-258 Cirugía del Uruguay; v. 41 n. 3 (1971): Cirugía del Uruguay; 250-258 1688-1281 0009-7381 reponame:Revista Cirugía del Uruguay instname:Sociedad de Cirugía del Uruguay instacron:Sociedad de Cirugía del Uruguay |
| dc.subject.none.fl_str_mv | hemorroides hemorragia colitis ulcerosa hemorrhoid hemorrhage ulcerative colitis |
| dc.title.none.fl_str_mv | Severe bleeding of colonic origin Hemorragias graves de origen colónico |
| dc.type.none.fl_str_mv | info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/publishedVersion |
| description | Serious colonic hemorrhages constitute an infrequent complication, but when they appear it is a grave emergency. They are somewhat more predominant in males, most frequently in aged persons. 69 % of the cases present intense acute anaemia; the remaining 31 % , modera te anaemia. It is easy to establish a diagnosis of hemorrhage but not a topographic diagnosis. Far this purpose it is useful to have tbe case hlstory; gastric probes are more adequa e than radiological study of the gastroduodenum. Radiological study of colon through ingestion is useful in discarding hemorr hages of the final intestinal loops; that of the colon by enema helps diagnosis in 60 % of cases. This is not the case with rectosigmoidoscopy and rectal tactile examination which serve to discard lesions of the anal canal. Two causes stand out in serious colonic hemorrhage: diverticular colopathy in the form of diverticular and colonic hemorrhagic arteriolopathies. The latter is more serious than diverticular colopathy because it affects patients with grave vascular liability and because there is direct bleeding of a vessel of important diameter with arteriosclerotic lesions. In such cases the procedure followed is an intense medica} treatment, but if this fails, surgery is employed. The following maneuvers described as complementary to the surgical act, performed in .order to establish the original site of the hemorrhage, were not satisfactory when we employed them: rectosigmoidoscopy with the assistence of the surgeon; intraoperatory coloscopy and segmentary intestinal lavage. The ideal treatment for these lesions is segnientary resection, but if the lesion is not found the surgeon should remember that he can resort to derivation colostomy, before effecting total colectomy. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | anni_b6bc7bcebcb2d084d598bd2d621c88d7 |
| instacron_str | Sociedad de Cirugía del Uruguay |
| institution | Sociedad de Cirugía del Uruguay |
| instname_str | Sociedad de Cirugía del Uruguay |
| language | spa |
| network_acronym_str | anni |
| network_name_str | oai-lr-anni |
| oai_identifier_str | oai:ojs2.revista.scu.org.uy:article/2165 |
| publishDate | 1971 |
| publishDateSort | 1971 |
| publisher.none.fl_str_mv | Sociedad de Cirugía del Uruguay |
| reponame_str | Revista Cirugía del Uruguay |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Severe bleeding of colonic originHemorragias graves de origen colónicoMañana, JulioGuicheff, Vladimirhemorroideshemorragiacolitis ulcerosahemorrhoidhemorrhageulcerative colitisSerious colonic hemorrhages constitute an infrequent complication, but when they appear it is a grave emergency. They are somewhat more predominant in males, most frequently in aged persons. 69 % of the cases present intense acute anaemia; the remaining 31 % , modera te anaemia. It is easy to establish a diagnosis of hemorrhage but not a topographic diagnosis. Far this purpose it is useful to have tbe case hlstory; gastric probes are more adequa e than radiological study of the gastroduodenum. Radiological study of colon through ingestion is useful in discarding hemorr hages of the final intestinal loops; that of the colon by enema helps diagnosis in 60 % of cases. This is not the case with rectosigmoidoscopy and rectal tactile examination which serve to discard lesions of the anal canal. Two causes stand out in serious colonic hemorrhage: diverticular colopathy in the form of diverticular and colonic hemorrhagic arteriolopathies. The latter is more serious than diverticular colopathy because it affects patients with grave vascular liability and because there is direct bleeding of a vessel of important diameter with arteriosclerotic lesions. In such cases the procedure followed is an intense medica} treatment, but if this fails, surgery is employed. The following maneuvers described as complementary to the surgical act, performed in .order to establish the original site of the hemorrhage, were not satisfactory when we employed them: rectosigmoidoscopy with the assistence of the surgeon; intraoperatory coloscopy and segmentary intestinal lavage. The ideal treatment for these lesions is segnientary resection, but if the lesion is not found the surgeon should remember that he can resort to derivation colostomy, before effecting total colectomy.Las hemorragias colónicas graves son una .complicación infrecuente, pero constituye una emergencia grave cuando se presenta. Tiene una ligera predominancia por el sexo masculino y se da frecuentemente en las personas de edad. El 69 % de los -casos ingresa con anemia aguda intensa, el 31 % restante con anemia moderada. El diagnóstico de hemorragia es fácil, no así el diagnóstico topográfico. Para esto sirve el anamnesis, el sondeo gástrico más que el estudio radiológico de gastroduodeno. El estudio radiológico de colon por ingestión ayuda a descartar las hemorragias de las últimas asas intestinales. El colon por enema realiza diagnóstico en el 60 % de los pacientes. No así la rectosigmoidoscopia ni el tacto rectal, estos sirven para descartar las lesiones del canal anal. Dos entidades se destacan francamente en las causas de las hemorragias colónicas graves: la colopatía diverticular en su forma de diverticulosis y la arteriolopatía hemorrágica colónica. Esta es más grave que la colopatía diverticular al asentar en pacientes con grave meiopragia vascular y porque sangra directamente un vaso de calibre importante con lesiones arterioscleróticas. La conducta frente a esos pacientes es realizar siempre un intenso tratamiento médico, si éste fracasa hay que recurrir al acto quirúrgico. Las maniobras que se han descrito como coadyuvantes en el acto quirúrgico, para localizar el sitio de origen de la hemorragia: la rectosigmoidoscopia asistida por el cirujano, la colonoscopia intraoperatoria y los lavados ségmentarios del intestino, en nuestras manos no fueron eficaces. Lo ideal para tratar estas lesiones es la resección segmentaria pero al no encontrar la lesión, el cirujano tiene que recordar que tiene en sus manos la colostomía de derivación antes de proceder a una colectomía total.Sociedad de Cirugía del Uruguay1971-02-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revista.scu.org.uy/index.php/cir_urug/article/view/2165Cirugía del Uruguay; Vol. 41 No. 3 (1971): Cirugía del Uruguay; 250-258Cirugía del Uruguay; Vol. 41 Núm. 3 (1971): Cirugía del Uruguay; 250-258Cirugía del Uruguay; v. 41 n. 3 (1971): Cirugía del Uruguay; 250-2581688-12810009-7381reponame:Revista Cirugía del Uruguayinstname:Sociedad de Cirugía del Uruguayinstacron:Sociedad de Cirugía del Uruguayspahttps://revista.scu.org.uy/index.php/cir_urug/article/view/2165/2087info:eu-repo/semantics/openAccessoai:ojs2.revista.scu.org.uy:article/21652026-06-16T04:48:24Z |
| spellingShingle | Severe bleeding of colonic origin Mañana, Julio hemorroides hemorragia colitis ulcerosa hemorrhoid hemorrhage ulcerative colitis |
| status_str | publishedVersion |
| title | Severe bleeding of colonic origin |
| title_full | Severe bleeding of colonic origin |
| title_fullStr | Severe bleeding of colonic origin |
| title_full_unstemmed | Severe bleeding of colonic origin |
| title_short | Severe bleeding of colonic origin |
| title_sort | Severe bleeding of colonic origin |
| topic | hemorroides hemorragia colitis ulcerosa hemorrhoid hemorrhage ulcerative colitis |
| url | https://revista.scu.org.uy/index.php/cir_urug/article/view/2165 |