文档介绍：呕血
hematemesis
消化道系统
定义:
呕血(hematemesis)是由上消化道疾病(指屈氏韧带以上的消化器官,包括食管、胃、十二指肠、肝、胆、胰疾病)或全身性疾病所致的急性上消化道出血,血液从口腔呕出。
病因
:
食管静脉曲张破裂
食管癌
食管异物
食管贲门粘膜撕裂(Mallory-Weiss)
:
消化性溃疡
急性胃粘膜病变
胃癌
Esophageal varices grade II (right) und grade III
(left). Cherry red spots are signs of imminent
hemorrhage (right). They correspond to areas
of especially thin and altered variceal wall.
This massive vessel with active bleeding was diagnosed in a 58 year- old
patient, who presented with tary stools. The first picture shows the lesion
after injection of fibrin glue. The right picture shows additionally applied
hemoclips. Bleeding stopped at the end of the procedure, but urred
twice before the patient had to be treated surgically. In dieu-la-foy ulcers
an arterial vessel of abnormal size reaches the mucosa causing a tiny
ulzeration by pression of the mucosal layer.
恶性溃疡:
深、大而不规则,边缘不整齐,底部深而不平,触之硬脆,易出血,活检可鉴别。
溃疡
良性溃疡:
圆形、椭圆形或线形,浅表或凹陷,底有苔(白、黄、黑),周边整齐、肿胀。分期有:活动期(A),愈合期(H),疤痕期(S)。
溃疡
With the inverted gastroscope a spurting hemorrhage from a fundal varice is
discerbnable. Hemostasis is achieved with several low volume injections of
Histoacryl - glue. The right picture shows the therapeutic ess.
、胆道疾病:
胃底及食管静脉曲张破裂出血
胆道出血:炎症、结石、蛔虫、肿瘤等均可引起出血
:
急性胰腺炎合并脓肿破裂出血
胰腺癌