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Studies on acute gastric mucosal lesion due to brain damage i. endoscopic study of upper gastrointestinal lesions following cerebrovascular accidents

Studies on acute gastric mucosal lesion due to brain damage i. endoscopic study of upper gastrointestinal lesions following cerebrovascular accidents

Okayama Igakkai Zasshi 96(11-12): 1027-1036

Endoscopic examinations were performed in 59 patients under general anesthesia just before or after surgery for cerebrovascular accidents. Acute gastric mucosal lesions were observed in 32 cases (54.2%). By the second day after the cerebrovascular accident, gastric petechiae and/or erosions in the corpus of the stomach were mainly observed. Acute duodenal ulcer became obvious from the third day after the accident. These upper gastrointestinal lesions were observed frequently in cases with low consciousness levels and cases with large hematomas. Gastrointestinal bleedings was observed in 19 cases. Bleeding in 6 cases observed by the second day after the cerebrovascular accidents was relatively mild. In contrast, bleedings in 7 cases observed 3 days after the third day from the accident was serious. Three patients died, and 2 cases underwent surgery stop to the bleeding. These data suggest that it is important to perform endoscopic examination in patients with cerebrovascular accidents as soon as possible to check for acute upper gastrointestinal lesions and bleedings. Mild bleeding observed by the second day after the accidents can be treated consecutively. In contrast, since the bleeding observed after the third day can potentially be severe, immediate endoscopic treatment or an emergency operation may be necessary to stop the bleeding.

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Accession: 006503946

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