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J St'ovícek

Publications and source records attributed to J St'ovícek.

4 recordsLinked to original sources
PubMed2004

[Endoscopic control of hemorrhage in the upper part of the digestive tract using hemostatic clips].

One of the endoscopy methods to stop upper gastrointestinal tract (GIT) bleeding in the limelight these days is hemostasis using metal clips. This method is indicated especially in patients with bleeding from an eroded artery and in patients where other hemostatic methods proved to be unsuccessful. Goal of our work was to assess successfulness of hemostasis, percentage of early rebleedings, and lethality of patients managed with this method. At the same time we present indications and locations of bleedings in these patients. We have retrospectively evaluated a group of 75 patients indicated for urgent endoscopy for GIT bleeding in a period from August 2000 till the end of February 2002. An average age of these patients was 69.7 years. We haven't managed to stop bleeding in 2 cases. In 12 patients (15.1%) rebleeding appeared within two days following intervention. From all the patients with early rebleeding: 4 patients had an ulcer and an eroded artery in stomach (4 died from bleeding, one of them undergone a surgery), 4 patients had an ulcer in duodenal bulb with artery at base (3 undergone surgery, 1 died), three patients had esophageal bleeding, and one patient had bleeding from the suture in stomach wall (undergone surgery and died). In majority of cases (82.8%) patients were managed with a combined technique (clip + adrenaline injection). With regard to a location of lesions treated with clip application, following locations were treated: esophagus 9.5%, stomach 40.5%, pylori channel 2.7%, duodenal bulb 39.2%, gastroenteroanastomosis 4.1%, D2 4.1%. Bleeding in 76% of patients was from an ulcer and artery (Forrest Ia, IIa). Results confirmed high effectiveness of hemostatic clips in primary hemostasis of GIT bleeding--in our sample more than 95%. An early rebleeding appeared in 15% of patients. Results presented correspond with data presented in world literature.

Aged↗
PubMed2004

[Acute hemorrhage of the upper part of the gastrointestinal tract--survey of emergency endoscopy of the upper gastrointestinal tract at our facility].

INTRODUCTION: Acute upper gastrointestinal tract bleeding is a cause of significant morbidity and mortality and is a reason for urgent endoscopy. Besides an age and associated diseases, prognosis of patients influence also localisation and type of bleeding. The aim of our retrospective analysis was to discover causes of bleeding into upper GI tract and its characteristics over a 4 year period. METHODOLOGY: A survey of urgent upper GI tract endoscopies in the Clinic of Internal Medicine in Motol in Prague because of an acute GI tract bleeding (hematemesis or melena) was done. Found ulcers were assessed using Forrest classification. Moreover, number and causes of recurrences of bleeding were also assessed. RESULTS: Within years 1998-2001 an urgent upper GI endoscopy because of bleeding (hematemesis or melena) was done in the Clinic of Internal Medicine in Prague in Motol in 1639 patients of an average age 62.2. 56% were men (average age 59) and 44% were women (average age 65.3). An endoscopy finding without pathology was present in 21.4%. The most frequent sources of bleeding were ulcers in duodenal bulb (20%), stomach ulcers (18.2%), and hemorrhagic gastropathy (16.5%) and varices (10.3%). Results of the Forrest classification in the ulcerative disease of stomach and duodenum were as follows: Forrest Ia 9.5%, Ib 24%, IIa 14.6%, IIb 18.7%, IIc 22.9%, III 10.3%. Recurrent bleeding was identified in 8.4% of patients, thereof bleeding from esophageal varices experienced 2.9% of patients (average age 45.8), bleeding from ulcers in bulbus 2.7% (Forrest Ib, IIa a IIb) of patients of an average age 62.6, and bleeding from ulcers in stomach 2.1% (Forrest Ia, IIa a Ib) of patients of an average age 62.5. Causes of recurrent bleeding were in one case bleeding from Barrett's oesophageal ulcer and in one case bleeding from ulcer in diaphragmatic hernia. Within 48 hours recurrent bleeding appeared in 65% of patients. CONCLUSION: Urgent endoscopy in gastrointestinal tract bleeding is an essential part of a complex medical care. It is highly reliable in identifying cause of bleeding, it enables to start treatment immediately and to consider prognosis of a patient.

Acute Disease↗