esophageal bleeding
Introduction
Introduction Acute mediastinal inflammation, esophageal pleural palsy, and possibly death may occur almost without exception due to diseases caused by instruments or foreign bodies with esophageal rupture and perforation as the main lesions. Due to the special anatomical location of the esophagus, it can be damaged by many different reasons. Although many advances have been made in thoracic surgery in recent years, the use of broad-spectrum antibiotics and better nutritional support has resulted in many improvements in the treatment of these diseases. . Since the esophagus has no serosa layer and is different from other parts of the digestive tract, it is more susceptible to damage.
Cause
Cause
Since the esophagus has no serosa layer and is different from other parts of the digestive tract, it is more susceptible to damage. The posterior wall of the esophagus is covered with a thin layer of fibrous membrane. The middle segment is covered only by the right pleura, the lower segment is covered by the left pleura, there is no soft tissue support around it, and the normal intrathoracic pressure is lower than atmospheric pressure. These are easy to esophagus. Anatomical factors of injury. Esophagitis (reflux esophagitis, esophageal diverticulitis), esophageal cancer, esophageal ulcer, esophageal and gastric mucosal tear, device examination or foreign body damage, radiation damage, strong acid and alkali cause chemical damage. Severe esophagitis can occur in esophageal mucosal hemorrhage, most of which is chronic small amount of bleeding.
Examine
an examination
Related inspection
Urinary total nitrogen gastritis meal angiography swallowing test endoscopy microendoscopy
Using a balloon catheter or a three-chamber balloon tube, the adult tube can also be used in children, but the length above the esophageal balloon should be appropriately shortened according to the length of the esophagus to prevent compression of the trachea. The bleeding site can also be identified while hemostasis. The nasal passage (infants can be orally) is inserted into the stomach, the airbag is blown, and after tightening, the tube is attached to the nose or traction, so that the stomach and the esophagus are separated into two chambers. Then insert another catheter into the esophagus with another nostril and rinse with saline (pay attention to a small amount of flushing to prevent water from entering the trachea). If there is no bleeding in the esophagus, it can be washed quickly. If there are still different degrees of bleeding during rinsing, it can be judged as esophageal bleeding.
Diagnosis
Differential diagnosis
General esophagus, stomach, duodenum and biliary bleeding can be identified and can be treated as necessary. If there is no endoscope condition, or the child cannot tolerate the endoscope. The most reliable hemostasis is surgery to stop bleeding. However, surgery requires certain conditions. The minimum condition is the approximate determination of the bleeding site, which determines the surgical approach and the choice of incision. At least to distinguish between esophageal hemorrhage or gastrointestinal bleeding to determine the opening of the chest or open exploration.
