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Gastrointestinal bleeding

Bleeding from the gastrointestinal tract are common, their main reason: the collapse of the tumor, located in the opening of the digestive tract or diffuse erosive and ulcerative lesions as a result of complications. Clinical manifestations of such bleeding depends primarily on the level of injury.

When bleeding from the mouth sick splovuyut blood and clots may be swallowing blood and vomiting "coffee grounds" ground (dihtopodibne black liquid stool), anemia.

Esophageal-gastric bleeding occur vomiting fresh blood with clots and "coffee grounds", melena, anemia.

Bleeding from the duodenum, biliary tract, pancreatic duct, jejunum accompanied with ground and anemia.

In cases where the source of bleeding is localized in the terminal small intestine and in the colon, the main symptom is the presence of unmodified blood in the stool.

To determine the treatment strategy must first clarify the nature and localization of bleeding. In diffuse lesions of the digestive tract or its parts shown haemostatic therapy in full.

In cases where the source of bleeding can be precisely localized, must together with the surgeon-oncologist to consider the possibility of surgery: tumors of the oropharynx - ligation of the external carotid artery or its branches; gastric cancer - endoscopic stop bleeding, palliative gastrectomy ( resection) or ligation of vessels in tumors intestine - palliative resection of the bowel. In all cases deciding on surgical intervention should be guided by considerations of expediency, the interests of the patient and the real prospect of continuing his life.

External bleeding

Bleeding from rozpadayuchyh, externally located tumors neridkisni in the practice of palliative medicine. To stop bleeding apply similar methods of hemostasis entire arsenal: pressing vessel that bleeds (not less than 25-30 minutes), pressure bandage, bandaging and suturing blood vessels in the wound and over, thermocoagulation, topical hemostatics ( Hemostatic sponge tahokomb, helfoum), the overall haemostatic therapy. If vaginal bleeding is widely used plugging the vagina. For emergency stop external bleeding is the most effective pressing vessels with subsequent stitching and overlay pressure bandage.

Of great importance is the proper organization of patient care: placement in a separate chamber, timely dressing, use a dark (preferably green) linen, which is less visible blood; sedative therapy; permanent residence at the nursing bed patient.

 

VII. Literature

7.1. Summary:

1) B ondar g. B., b and itenko. C., p opovych Oh. Yu p aliatyvna medical care

The manual for students of V - VI courses, medical interns and family physicians., D onetsk 2004.

2)               Bilynsky BT Oncology, Lviv, 1998.

3)               Bilynsky BT Oncology, Lviv, 1992.

4)               Peterson BE CANCER, M.: Medicine, 1980

5)               Slynchak SM - CANCER, M.: Medicine, 1981.

6)               Trapeznikov NN CANCER, M.: Medicine, 1981.

7)               Lecture material.

7.2. More:

Clinical CANCER. Moscow: Medicine, 1971. - Vol.1. - 440 p.

The total CANCER. Guide for doctors. L.: Medicine, 1989. - 646 p.

CANCER. Dictionary-Handbook. Y.V.Kasyanenko, V.H.Pynchuk, D.V.Myasoedov and others Kiev.: Naukova Dumka, 1992.

Tumors: carcinogenesis, tumor classification, general principles of diagnosis and treatment (Methodological development for students). Lviv, 1993. - 13 p.

Peterson BE General Principles of diagnosis zlokachestvennыh tumors. Moscow: Medicine, 1968.

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