DISEASES OF THE UPPER GASTROINTESTINAL TRACT IN PATIENTS WITH OCCLUSIVE PATHOLOGY OF THE ABDOMINAL AORTA AND LOWER EXTREMITY ARTERIES

A.A. Fokin, Ye.R. Olevskaya, L.A. Orekhova, I.A. Andriyevskikh, O.F. Kalyov, I.M. Sakhnin
Chair of Hospital Surgery,Chelyabinsk Medical Academy,
Chelyabinsk Regional Hospital,
Chelyabinsk, Russia

Altogether 747 patients with occlusive diseases of the abdominal aorta and lower extremity arteries underwent fibroesophagogas troduodenoscopy (FEGDS) with biopsy of gastric mucosa and measurement of gastric juice acidity. In this patient group, the pathological conditions revealed in the upper gastrointestinal tract (GIT) were many and varied. Gastroduodenal ulcers and erosions accounted for 33.5%, carcinoma of the stomach was discovered in 1.1% of patients. These diseases may cause serious complications in the intra- and postoperative periods or result in tactic errors in the patient management. The majority of morphological examinations identified high-active gastritis and infection with Helicobacter pylori (HP). Hypoacidic conditions of gastric secretion were encountered much more often. Analysis was made of potential ulcerogenic factors: microcirculatory impairment of the mucosa, aggressive action of some drugs, HP infection, stressful condition of the patient awaiting surgical intervention, etc. Only 6% of all the patients had special «gastric» complaints. In the remaining patients, gastroduodenal ulcers were a casual finding at diagnostic FEGDS. Taking into account the clinical, endoscopic and morphological aspects of gastroduodenal pathology in patients with occlusive diseases of the aorta and lower extremity arteries we think it reason able to include FEGDS into a complex of examinations accomplished at the preoperative stage for the purpose of early detection of pathology and administration of the proper treatment. This will allow to avoid unjustified GIT complications and to choose the correct treatment policy.

P. 119

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