Kirurško liječenje gastrointestinalnih krvarenja u dječjoj dobi

master's thesis

• Title (english): Surgical treatment of gastrointestinal bleedings in pediatric pacients
• Author: Ante Vuković
• Mentor: Stjepan Višnjić (mentor)
• Committee member: Goran Augustin (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Stjepan Višnjić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Gastrointestinalna krvarenja dijelimo na krvarenja gornjeg i donjeg gastrointestinalnog sustava. Gastrointestinalno krvarenje prezentira se melenom, hematohezijom i hematemezom. Melenom opisujemo pojavu crne stolice. Hematohezija jest pojava svježe, crvene krvi u stolici. Hematemeza označava povraćanje krvi. Najčešći uzroci gastrointestinalnog krvarenja u dječjoj dobi su gastroezofagealna refluksna bolest, varikoziteti jednjaka, Meckelov divertikulum, juvenilni polipi. Sustavne upalne bolesti, Crohnova bolest i ulcerozni kolitis, u svojim akutnim fazama prikazuju se gastrointestinalnim krvarenjem. Ključna zadaća kod pacijenta s gastrointestinalnim krvarenjem jest klinička procjena i stabilizacija suportivnim mjerama. Znakovi koji nam ukazuju na akutno ugroženog pacijenta zbog krvarenja jesu hipotenzija, tahikardija, poremećaji svijesti, bljedoća kože i sluznica. Najbitniji postupak kod akutnog zbrinjavanja pedijatrijskog pacijenta s gastrointestinalnim krvarenjem jest nadoknada tekućine putem kristaloidnih i koloidnih otopina te svježe smrznute plazme . Dijagnostika gastrointestinalnih krvarenja sastoji se od laboratorijskih pretraga, endoskopskih metoda prikaza gastrointestinalnih krvarenja i radioloških pretraga. Farmoterapija kod gastrointestinalnih krvarenja sastoji od inhibitora protonske pumpe, vazoaktivnih lijekova kao što je somatostatin i beta blokatora koji se najšire koriste kod varikoziteta jednjaka. Endoskopija jest glavni modalitet kod zbrinjavanja krvarenja nastala zbog varikoziteta jednjaka te određenih intraluminalnih lezija u probavnom sustavu. Kirurške metode resekcije i anastomoze koriste se kod Meckelovog divertikuluma, varikoziteta jednjaka i juvenilnog polipa kao uzroka gastrointestinalnog krvarenja u dječjoj dobi.

Abstract (english)

Gastrointestinal bleedings are divided into upper and lower gastrointestinal bleeding. Gastrointestinal bleeding presents with melena, hematochezia and hematemesis. Melena is described as appearance of black stools. Hematochezia is the appearance of fresh, red blood in the stool. Hematemesis means vomiting of blood. The most common causes of gastrointestinal bleeding in children are gastroesophageal reflux disease, esophageal varices, Meckel's diverticulum, and juvenile polyps. Systemic inflammatory diseases, Crohn's disease and ulcerative colitis, in their acute stages are manifested by gastrointestinal bleeding. The key task in a patient with gastrointestinal bleeding is clinical assessment and stabilization with supportive measures. Signs that indicate a patient in acute danger due to bleeding are hypotension, tachycardia, disturbances of consciousness, pallor of the skin and mucous membranes. The most important procedure in the acute treatment of a pediatric patient with gastrointestinal bleeding is fluid replacement through crystalloid and colloid solutions and fresh frozen plasma. Diagnostics of gastrointestinal bleeding consists of laboratory tests, endoscopic methods of imaging gastrointestinal bleeding, and radiological examinations. Pharmacotherapy for gastrointestinal bleeding consists of proton pump inhibitors, vasoactive drugs such as somatostatin and beta blockers, which are most widely used in esophageal varices. Endoscopy is the main modality in treating bleeding caused by esophageal varices and certain intraluminal lesions in the digestive system. Surgical methods of resection and anastomosis are used for Meckel's diverticulum, esophageal varices and juvenile polyps as causes of gastrointestinal bleeding in children.

• Keywords: Gastrointestinalno krvarenje; kirurško liječenje; djeca
• Keywords (english): Gastrointestinal bleeding; surgical treatment; children
• Language: croatian
• URN:NBN: urn:nbn:hr:105:741794
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-23 09:21:36