ترجمه مقاله نقش ضروری ارتباطات 6G با چشم انداز صنعت 4.0
- مبلغ: ۸۶,۰۰۰ تومان
ترجمه مقاله پایداری توسعه شهری، تعدیل ساختار صنعتی و کارایی کاربری زمین
- مبلغ: ۹۱,۰۰۰ تومان
INTRODUCTION
Gastrointestinal bleeding, responsible for 612,000 hospital days and $1.2 billion in aggregate health care expenditures in 2009,1 is a common clinical problem encountered by general surgeons. Hospitalization for gastrointestinal bleeding increased 22% between 2000 to 2009,1 likely a consequence of an increasing elderly population and proliferating anticoagulant usage. Hematochezia or melena are frequent clinical impetus for patients to seek evaluation. Although not definitive for localization, their presence in the absence of hematemesis raises the suspicion of lower gastrointestinal bleeding (LGIB), defined as gastrointestinal bleeding with a source distal to the ligament of Treitz. LGIB is associated with colonic sources, such as diverticulosis or angiodysplasia, but can include small bowel sources. LGIB outcomes are more favorable than upper gastrointestinal bleeding (UGIB) and 80% resolve spontaneously.2 Less invasive efficacious interventions likely contributed to the decline in mortality and morbidity over the preceding 20 years.
SUMMARY
LGIB is a common entity in general surgery practice. Familiarity with the various diagnostic and therapeutic modalities is necessary for optimal patient care. Evolving resuscitation strategies, pharmaceuticals, diagnostic technology, and management devices are altering traditional management algorithms. As less invasive interventions become more efficient, surgical interventions are becoming less frequent. With experience in managing hemorrhagic shock, endoscopy, and definitive surgical interventions, the surgeon knowledgeable of the evolving practice landscape is wellpositioned to provide efficient and complete care to most patients with LGIB.