DEEP VEIN THROMBOSES ASSOCIATED WITH BLEEDING GASTRODUODENAL ULCER
DOI:
https://doi.org/10.11603/2414-4533.2024.2.14699Keywords:
bleeding gastroduodenal ulcer, deep vein thrombosisAbstract
The aim of the work: to assess the risk of venous thrombosis in patients with bleeding gastroduodenal ulcers who underwent hemostatic therapy and to determine the appropriate treatment strategies.
Materials and Methods. Data of 18 patients who were treated for acute deep vein thrombosis of the lower limbs associated with bleeding gastroduodenal ulcers in 2023 were analyzed. The analysis included the degree of blood loss, the use of endoscopic coagulation and hemostatic therapy, transfusion of blood components, coagulation system status, and VTE risk assessment using the Caprini scale. Control groups consisted of patients with bleeding ulcers without thromboembolic complications. Group I included patients with the second-degree of blood loss, while Group II included patients with the third-degree of blood loss, who received both antihemorrhagic medication therapy and transfusions of plasma and blood components.
Results and Discussion. Bleeding from gastroduodenal ulcers is associated with changes in the coagulation and fibrinolytic systems of the blood and is a risk factor for deep vein thrombosis (DVT) in the early post-hemorrhagic period. The risk of DVT increases with the degree of blood loss, the volume of hemostatic therapy, and the transfusion of plasma and blood components. All patients with DVT associated with bleeding gastroduodenal ulcers were prescribed anticoagulant therapy. Patients classified as Forrest III received full doses of anticoagulants, while those classified as Forrest II, due to the risk of rebleeding, started with half doses. On the 4th-5th day, after negative fecal occult blood tests, they started receiving the therapeutic doses of rivaroxaban and discharged for outpatient treatment. All patients were discharged in satisfactory condition. The duration of anticoagulant therapy lasted 3-6 months. All patients have shown positive dynamics: DVT symptoms regressed, and venous recanalization occurred. During this period, no cases of recurrent bleeding from gastroduodenal ulcers were recorded.
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