Jurnalul de Chirurgie

Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | miercuri, 21 august 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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| Romana

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Colegiul Medicilor

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ULCERELE DE STRES - ULCERELE CUSHING: DIAGNOSTIC, TRATAMENT, PROFILAXIE
R. Şcerbina, G. Ghidirim, A. Dolghii, V. Lescov,
V. Burunsus, I. Glavan, Liliana Florea
Catedra chirurgie Nr. 1 „N. Anestiade”
Universitatea de Stat de Medicină şi Farmacie „N. Testemiţanu” Chişinău, Republica Moldova
Jurnalul de chirurgie (Iaşi). 2012; 8(4): 387-391
Full text: Format PDF (Română/Romanian)

Abstract:

BACKGROUND: Cushing ulcers appear at the 3rd to 5th day after stress situations accompanied with hemorrhage in 5-10%, perforations in 4%. METHODS: Between 2007-2011 in the National Scientific and Practical Center for Emergency Medicine Kishinev, 1917 patients with superior gastric hemorrhages were treated, from which 139 in ICU. RESULTS: In 45 cases were diagnosed Cushing ulcers: men – 30, women – 15 with age between 21 years and 87 years. The disease causes were: cerebral vascular diseases 13(28.8%); fractures with hip replacement – 16 (35.5%); chronic renal insufficiency and septic states - 3 (12.32%); severe head trauma – 10 (22.2%). The mortality rate was 22.2% (10 patients). Gastroscopy revealed hemorrhages followed by endoscopic hemostasis. For the prophylaxis of hemorrhage relapse all patients underwent repeated endoscopic hemostasis 2 to 3 times. One patient was operated for a perforated bulbar Cushing ulcer and another one due to Forrest IA hemorrhage that didn’t respond to endoscopic hemostasis – Bilroth I antrum resection. Both patients died due to multiple organ dysfunction syndrome (MODS). Patients with Cushing ulcers received anti-ulcer treatment: PPI, H2 blockers in maximum dosages, hemostatic and repeated blood plasma transfusions. CONCLUSIONS: Gastroscopy is obligatory in all patients with severe head trauma, septic states, chronic renal insufficiency and severe cerebral vascular diseases. Anti-ulcer and hemostatic treatment insures ulcer healing and scarring in most of the cases.

KEY WORDS: CUSHING ULCERS; DIAGNOSIS; TREATMENT

HOW TO CITE: Şcerbina R, Ghidirim Gh, Dolghii A, Lescov V, Burunsus V, Glavan I, Florea L. [Stress ulcers - Cushing ulcers: diagnosis, treatment, prevention]. Jurnalul de chirurgie (Iaşi). 2012; 8(4): 387-391.

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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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