The role of etiopathogenetic aspects in prediction and prevention of discontinuous-hemorrhagic (Mallory-Weiss) syndrome

Cherednikov, Evgeniy; Kunin, Anatoly A.; Cherednikov, Evgeny E.; Моисеева, Н. С.

doi:10.1186/s13167-016-0056-4

Cited by 16 publications

(14 citation statements)

References 5 publications

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“…Indeed, the posterior and lateral sections of the esophagus are fixed by ligaments and display less elasticity; this means that the probability of laceration of the mucosa in the event of an increase in intragastric pressure is greater in this region than in the left regions (which are more flexible and mobile). [9]…”

Section: Discussionmentioning

confidence: 99%

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Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data

Cuccì

Caputo

Orcioni³

et al. 2018

Medicine

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Rationale:Spontaneous esophageal rupture (Boerhaave syndrome) is a rare, though frequently fatal, event. It is generally caused by a sudden increase in pressure inside the esophagus. In some cases, full-thickness perforations of the esophagus may develop from previous lesions that initially involve only the esophageal mucosa (Mallory-Weiss syndrome) and which, following further triggering events, give rise to a transmural lesion.Patient concerns:Here, we present the case of a 45-year-old subject who suddenly died of acute cardio-respiratory failure, an autopsy was performed to identify the cause of death.Diagnosis, interventions, and outcomes:The autopsy examination revealed a full-thickness rupture of the esophageal wall. Through the integration of necroscopy findings, anamnestic data, and histopathological examination, it has been possible to establish that complete esophageal rupture resulted from the evolution of a previous partial lesion of the esophageal wall, and that an untreated Mallory-Weiss syndrome evolved into a rapidly fatal Boerhaave syndrome.Lessons:This case shows that distal esophageal tears, rather than constituting a distinct entity, may be part of a spectrum of diseases and that a partial lesion of the esophageal wall caused by barogenic injury may evolve into a full-thickness rupture following further barotraumas.

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Section: Discussionmentioning

confidence: 99%

“…Other precipitating factors include: severe coughing, acute asthma, epilepsy, constipation, childbirth, lifting weights, thoraco-abdominal traumas, and endoscopy maneuvers. [9,10]…”

Section: Introductionmentioning

confidence: 99%

Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data

Cuccì

Caputo

Orcioni³

et al. 2018

Medicine

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“…Ввиду отсутствия специфичности клинической картины данного состояния нередко устанавливают ошибочный диагноз -острый инфаркт миокарда, пневмония, острый панкреатит. Запоздалая или неверная постановка диагноза обусловливает высокую смертность: от 10 до 25% пациентов погибают в первые 24 ч после начала лечения, до 40-60% пациентов -в течение 48 ч [15].…”

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Features of managing patients with gastrointestinal bleeding in resuscitation and intensive care units

Bayalieva

Жолдошевна²,

Zefirov³

et al. 2019

Kazan Med J

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Emergency hospital doctors very often encounter cases of gastrointestinal bleeding. Known causes of such bleeding are peptic ulcers of the stomach and duodenum and esophageal varices in portal hypertension. But there are cases of gastrointestinal bleeding, when the diagnosis is not easy to establish, treatment is carried out symptomatically and fatal dangers for the patient are often underestimated. Bleeding is often massive and difficult to assess in terms of volume as blood is in the gastrointestinal tract and only changes in hemodynamics and blood tests can serve as indirect indicators of blood loss. Carrying out intensive care and resuscitation measures simultaneously with endoscopic and surgical methods to stop bleeding determine a high risk and dramatic situation. On the background of hypocoagulation syndromes associated with the use of anticoagulants and antiplatelet agents, the course of these syndromes is significantly complicated. A major contribution to the adverse outcome of the disease is brought by severe concomitant diseases and old age. Intensive care for this category of patients requires an individual approach, taking into account the underlying disease and the cause of bleeding, as well as comorbidities. Endoscopic methods of vascular coagulation are the main ways for diagnosing and stopping bleeding, but in extreme cases urgent surgical intervention is necessary. Patients require treatment in multidisciplinary clinics, where there is an expanded diagnostic service, endoscopic service, departments of abdominal and thoracic surgery, transfusion and resuscitation departments and intensive care with extended options for replacement therapy of vital organs. The article provides a review of the causes, diagnosis and methods of intensive treatment of upper gastrointestinal bleeding from esophagus and stomach in MalloryWeiss and Boerhaave syndromes.

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“…(1)(2)(3) Timely diagnosis of symptomatic gastroduodenal erosions and ulcers is a challenge that still does not have a solution because 30%-90% of patients have an asymptomatic course of these conditions, 46%-58% patients do not display a typical clinical performance, and in 25%-42% of patients, symptoms of the underlying condition prevail. In most cases, acute erosions and ulcers are diagnosed only in cases of bleeding or autopsy.…”

Section: Introductionmentioning

confidence: 99%

A Complex, Multidisciplinary Approach to Prevention of Gastro-Duodenal Bleeding in Therapeutic Patients of a General Hospital

Budnevsky¹,

Cherednikov²,

Попов³

et al. 2017

IJBM

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The aim of this study was to make the prevention of erosive-ulcerous gastroduodenal bleeding (EU-GDB) more efficient in therapeutic patients admitted to a general hospital by using a multidisciplinary approach that includes a diagnostic algorithm, treatment protocol, and individual methods of EU-GDB prevention. Materials and Methods:The study included 114 patients of the therapeutic, pulmonary, and cardiology departments of the Voronezh City Emergency Care Hospital. The patients had been admitted due to destabilization of their underlying conditions and displayed signs of acute gastroduodenal erosions and ulcers during their stay in the hospital. All the patients were randomly divided into two equal groups: the main group and the comparison group. A multidisciplinary approach was applied to patients of the main group (n=58; mean age, 62.64±14.37); it included early pre-clinical diagnosis of erosive-ulcerous gastroduodenal impairments (EU-GDI) by fibrogastroduodenoscopy on the second or third day after their admission to the hospital, which helped to reveal in a timely manner uncomplicated EU-GDI and directly start local treatment as a part of complex therapy. An algorithm of the procedure provides for participation of a surgeon. Powder-like biologically active granular sorbents of the new generation (ASEPTISORB-A, ASEPTISORB-D, or ASEPTISORB-DT) were applied to the revealed acute erosions and gastroduodenal ulcers during the FGDS procedure to prevent hemorrhagic complications. After manifestation of the first signs of EU-GDB: during the curative endoscopy, the use of the developed minimally invasive method of endoscopic hemostasis, which provided combined application of a local haemostatic preparation Gelplastan and ASEPTISORB-D to the defect area. In the comparison group (n=56), the traditional technique of surgical consultations "on demand" was used. FGDS was performed when first symptoms appeared. Common methods of endoscopic hemostasis without local treatment of EU-GDI and application of granulated sorbents were used in this group.Conclusion: The developed program helps to prevent hemorrhagic complications, exclude emergency operations, and reduce mortality rate by 3 times.

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The role of etiopathogenetic aspects in prediction and prevention of discontinuous-hemorrhagic (Mallory-Weiss) syndrome

Cited by 16 publications

References 5 publications

Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data

Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data

Features of managing patients with gastrointestinal bleeding in resuscitation and intensive care units

A Complex, Multidisciplinary Approach to Prevention of Gastro-Duodenal Bleeding in Therapeutic Patients of a General Hospital

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