Przyczyny krwawienia do światła przewodu pokarmowego
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Przyczyny krwawienia do światła przewodu pokarmowego

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Czynników ryzyka wystąpienia krwawienia do światła przewodu pokarmowego jest wiele. Zależą one od odcinka przewodu pokarmowego w którym doszło do krwawienia.

W górnym odcinku przewodu pokarmowego źródłem krwawienia jest zazwyczaj wrzód żołądka i dwunastnicy (35-50 proc.) oraz nadżerki błony śluzowej żołądka towarzyszące zapaleniu błony śluzowej. Te dotyczą 8-15 proc. przypadków.

Ponadto źródłem krwawienia w tym obszarze są również zmiany naczyniowe, w tym angiodysplazje i wrzód Dieulafoya (5 proc.), nowotwory przełyku i żołądka (1 proc.), a także pęknięcie błony śluzowej przełyku (zespół Mallory’ego-Weissa).

Krwawienie w górnym odcinku światła przewodu pokarmowego może towarzyszyć także żylakom przełyku i dna żołądka oraz przetokom górnego odcinka przewodu pokarmowego.

Krwawienie w dolnym odcinku przewodu pokarmowego najczęściej świadczy o uchyłkach jelit (60 proc.) oraz nieswoistych chorobach zapalnych jelita grubego (13 proc.), takich jak wrzodziejące zapalenia jelita grubego, choroba Leśniowskiego-Crohna czy niedokrwienne zapalenia jelita grubego. Źródłem krwawienia w tym obszarze mogą być również żylaki odbytu (11 proc.), nowotwory jelita grubego (9 proc.), malformacje naczyniowe (3 proc.), jak również przetoki dolnego odcinka przewodu pokarmowego.

Do krwawienia w świetle przewodu pokarmowego, zarówno w górnym, jak i dolnym odcinku może dojść również na skutek przyjmowania leków z grupy niesteroidowych leków przeciwzapalnych, takich jak m.in. acenokumarol.

Źródło: Głuszek S., Chirurgia Podstawy, Wydanie II uaktualnione i rozszerzone Warszawa 2019, s. 137-138

Przeczytaj także: Czynniki ryzyka powikłań leczenia neurochirurgicznego

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