Novosti
Khirurgii
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Year 2017 Vol. 25 No 5

REVIEWS

DOI: https://dx.doi.org/10.18484/2305-0047.2017.5.518   |  

I.N. KLIMOVICH, S.S. MASKIN, P.V. ABPAMOV

DIAGNOSIS AND TREATMENT OF SYNDROME OF INTESTINAL INSUFFICIENCY IN ACUTE BLEEDING FROM UPPER GASTROINTESTINAL TRACT

FSBEE HE Volgograd State Medical University, Volgograd,
The Russian Federation

Acute massive bleeding from the gastroduodenal zone leads to the development of the syndrome of intestinal insufficiency (SII), due to ischemia/reperfusion injury of the intestinal wall. Violation of the barrier functions of the intestinal wall causes a massive inflow of the toxins from the intestine to the portal circulation and intestinal lymphatic collector that triggers multiple organ failure. As a result the issue of early diagnosis of the SII arises urgently, which currently represent a wide range of invasive biochemical studies, studying of myoelectric parameters and sonography data. However, taking into consideration the complicated, multilateral nature of the pathogenesis of intestinal insufficiency, it is extremely difficult to differentiate the most informative one. At a result, in the clinical practice there is no established strategy of SII treatment in the gastrointestinal bleeding (GIB). The main tendencies of SII therapy are limited by intraintestinal detoxification and correction of oxidative stress. This explains a large number of experimental studies in which using the modeling of hemorrhagic hypotension and intestinal ischemia/reperfusion lesions, the possibilities of supporting its secretory and kinetic functions, the correction of metabolic disorders and regenerating mechanisms, the enhancement of antioxidant and anti-inflammatory abilities are studied.
However, despite the large arsenal of experimental and clinical investigations, the issues of early detection and etiopathogenetic treatment of SII are far from being solved and require further study.

Keywords: syndrome of intestinal insufficiency, gastrointestinal bleeding, ischemia, diagnostics of intestinal insufficiency, treatment of intestinal insufficiency, intestinal wall
p. 518-524 of the original issue
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Address for correspondence:
400131, Russian Federation,
Volgograd, Fallen Fighters Sq., 1,
FGBOU VO Volgograd State
Medical University,
department of Hospital Surgery,
Tel.: + 905 336-23-69,
E-mail: klimovichigor1122@yandex.ru
Igor N. Klimovich
Information about the authors:
Klimovich I.N., MD, Associate Professor of the Hospital Surgery Department of FSBEE HE Volgograd State Medical University.
Maskin S.S., MD, Professor, Head of the Hospital Surgery Department of FSBEE HE Volgograd State Medical University.
Abramov P.V., Post-Graduate Student of the Hospital Surgery Department of FSBEE HE Volgograd State Medical University.
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