Hematemesis - bloody vomiting, symptom of gastric or intestinal (duodenum) bleeding.
Hematemesis more often causes ulcerative disease. But we should not forget about the possibility of stomach cancer, as well as hernia hiatal. In some cases, the cause of hematemesis may be the action of certain drugs (acetylsalicylic acid, reserpine, steroid hormones, phenylbutazone, anticoagulants) during the continuing use or high sensitivity to the patient. Often hematemesis caused by varicose veins of the esophagus and cardia stomach-related cirrhosis. Sometimes caused hematemesis may be kidney, liver and vitamin deficiency.
Small bleeding, accompanied by hematemesis, cause only the weak, when the massive may collapse (see) as a result of blood loss. To identify the cause of hematemesis not easy. Diagnosis of hematemesis on the ground ulcer disease help anamnesis, the remission of pain during bleeding, floor patients (men bleeding from ulcers observed several times more often than women), and finally age (30 - 50 years). When localization of ulcers in the duodenum, hematemesis often accompanied tarry stools (see Melena). Old age, weight loss, increasing weakness, achlorhydria in anamnesis allows to suspect stomach cancer. The assumption of bleeding from the esophageal veins confirms, in addition to anamnesis, visible eye saphenous vein to the anterior abdominal wall, enlarged liver and spleen.
Treatment. First aid: in identifying hematemesis prescribe the patient at rest, lay in bed with a slightly higher torso and head, to prevent aspiration of vomitus in the respiratory tract; belly - an ice pack, prohibit and fluid intake. Urgent hospitalization in the surgical hospital. Patients are evacuated only on a stretcher and lying on his back. The basic principles for the treatment of acute gastric or intestinal bleeding: full peace, removing the patient from collapse, bleeding, designation of one of narcotic drugs - omnopon (1 % solution of 1 ml), promedol (2% solution of 1 ml), morphine (1% solution of 1 ml) under the skin. In the first 24-48 hours hunger; the providing of water for rinsing of the mouth.
In order to stop the bleeding drip blood transfusion (75-100 ml). If continued bleeding repeated blood transfusions, erythrocyte mass (100-125 ml)plasma or serum (50-150 ml).
To compensate loss of fluid and thirst in the first 3 days make a drip 300 ml of 5% solution of glucose or izotoniceski solution of sodium chloride every 6 hours. through the rectum.
When kollaptoidnye condition injected drip way norepinephrine (0.1% solution of 1 ml 5% glucose solution), appoint mezaton (1% solution of 1 ml) under the skin. In 2-4 days after stopping bleeding begin to feed the patient liquid cooled food in small portions. In the absence of the effect of conservative treatment shown urgent surgery.