Conocimientos vigentes en torno a la hemorragia digestiva alta varicosa

Olga Magdalena Moreira Barinaga, Zenén Rodríguez Fernández, Ernesto Manzano Horta, Sinuhé Rodríguez Hung, Ana María Nazario Dolz, Isabel Maurelo Martínez Pinillo

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Resumen

Las hemorragias que ocurren en el tubo digestivo y en particular las de origen varicoso, constituyen una urgencia médico quirúrgica; a pesar de los avances científico tecnológicos actuales, su pronóstico continúa reservado. Esta revisión, se realizó con el propósito de profundizar en diversos aspectos cognoscitivos vigentes sobre la hemorragia digestiva varicosa. Se llevó a cabo una revisión documental mediante búsqueda temática digital de artículos nacionales y foráneos, publicados en español e inglés durante la presente centuria, concernientes a la hemorragia digestiva varicosa. Existe diversidad de criterios en torno al diagnóstico y tratamiento del sangrado digestivo alto varicoso. Se evidencia la necesidad de una unidad de atención a estos pacientes en los hospitales, la disponibilidad de endoscopia digestiva superior a tiempo completo y de un equipo multidisciplinario para brindar una terapia integradora. El acto operatorio programado solo debe ejecutarse en la clase Child-Pugh ideal, pero como las intervenciones suelen ser urgentes en estadio B o C, se elevan las probabilidades de complicaciones y muerte. Las várices esofagogástricas, a pesar de considerarse una causa infrecuente de hemorragia digestiva alta, tiene por lo general un desenlace tórpido en quienes la presentan, de manera que el diagnóstico y tratamiento adecuados constituyen un verdadero desafío para cualquier servicio quirúrgico.

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