L'OESO GASTRO DUODENOSCOPIE DANS LES HEMORRAGIES DIGESTIVES AIGUES DES CIRRHOSES

Abstract

Over a period of 20 yr, the authors have carried out 1420 high endoscopies as an emergency for hematemesis and/or melena. Out of these 1420 endoscopies 122 (8.6%) were carried out in cases of definitive cirrhosis and 64 (4.5%) in chronic alcoholics. Among the patients with cirrhosis of the liver, esogastric endoscopy showed the presence of esophageal varices in 86 cases (70.5%). In 31 of them (25.4%) rupture of the varices was demonstrated. This study included 3 periods, depending on the type of endoscope used: from 1952 to 1966, gastroflex OPL; from 1966 to 1971, gastrofibroscope Olympus GIFA and GFB, esophagoscope Olympus EF; and between 1971-1972, introduction of the JF duodenoscope and the GIFD gastro bulboscope. The percentage of undetermined hemorrhagic lesions passed from 40% in 1952-1966 to 28% from 1966-1971, and 4.5% between 1971-1972. The lesions responsible for the hemorrhage in cirrhotic patients were rupture of varices in 25.4% of cases, erosive gastritis in 23%, gastric ulcer in 10%, Mallory Weiss syndrome in 4.9% and duodenal ulcer in 4%. In alcoholics the most frequent lesion was gastric ulcer in 36% of cases, followed by erosive gastritis in 26%; Mallory Weiss syndrome was noted in 20% of cases, and duodenal ulcer in 9%. A certain number of patients had several hemorrhagic lesions on endoscopy; the association of varices and erosive gastritis was the most common. In one recent case, 3 lesions were found: rupture of varices, gastric erosions and a bleeding ulcer.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe