Mide Kanamaları ve Tedavisi
Özet
Üst gastrointestinal sistem (GİS) kanamaları, ağızdan Trietz ligamentine kadar olan bölgede meydana gelen ve ciddi morbidite ile mortalite riski taşıyan önemli bir klinik tablodur. Mide kanamaları bu grupta geniş bir yer tutmakta olup, en sık peptik ülser hastalığı, eroziv gastrit, gastrik varisler, portal hipertansif gastropati ve Mallory-Weiss sendromu gibi etiyolojilerden kaynaklanmaktadır. Hastalar genellikle hematemez ve melena şikayetleriyle başvurur. İlk değerlendirmede hastanın vital bulgularının takibi, laboratuvar testleri ve hemodinamik stabilizasyonun sağlanması kritik önem taşır. Resüsitasyon sürecinde sıvı desteği ve gerekli durumlarda kan transfüzyonu uygulanır. Tanı ve tedavide ilk tercih olan endoskopinin yanı sıra asit baskılanması amacıyla proton pompa inhibitörleri (PPİ) ve varis kanamalarında vazoaktif ilaçlar kullanılır. Medikasyon ve endoskopik yöntemlerle kontrol altına alınamayan masif kanamalarda ise cerrahi müdahale veya radyolojik girişimler devreye girer.
Upper gastrointestinal (GI) bleeding originates between the mouth and the ligament of Treitz, presenting a significant clinical condition with a high risk of morbidity and mortality. Gastric bleeding constitutes a large portion of these cases, primarily driven by etiologies such as peptic ulcer disease, erosive gastritis, gastric varices, portal hypertensive gastropathy, and Mallory-Weiss syndrome. Patients typically present with hematemesis and melena. During the initial evaluation, monitoring vital signs, conducting laboratory tests, and achieving hemodynamic stabilization are critically important. Fluid resuscitation and, when necessary, blood transfusions are administered during the stabilization phase. Endoscopy serves as the primary tool for both diagnosis and treatment, supplemented by proton pump inhibitors (PPIs) for acid suppression and vasoactive drugs for variceal bleeding. For massive hemorrhages that cannot be controlled via medical or endoscopic interventions, surgical management or radiological procedures are utilized.
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