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Erosion of the stomach and duodenum 12: diagnosis
Last reviewed: 23.04.2024
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Laboratory and instrumental data
1. There are two main types of erosion in the FEGDS:
- flat (acute, hemorrhagic, incomplete) - superficial defects of the mucosa (point, linear, polygonal) usually up to 0.5 cm in diameter; they can be single or multiple, covered with fresh blood, hydrochloric acid hematin or fibrin. These changes are revealed against a background of hyperemic and edematous mucous membrane; less often it is unchanged;
- chronic (full, uplifting) erosion - in the form of small bulging of the mucosa with raised edges along the entire circumference and a depression in the center; they can be covered with fibrinous coating and resemble skin changes with smallpox ("varioloform erosion").
FEGDS makes it possible to distinguish between mature and immature chronic complete erosion. Immature full erosions are those that have only a corolla of hyperemia on top. Mature erosions are considered if there are signs of desquamation and necrosis. Immature erosions are observed in the phase of remission, mature - in the phase of exacerbation.
Erosion of the stomach should be carefully differentiated with an erosive-ulcerative form of cancer, for which it is necessary to conduct a biopsy from suspicious areas of the mucosa with subsequent morphological examination.
It is also necessary to carry out research aimed at detecting Helicobacteria .
- X-ray examination: when using the technique of double contrasting of the stomach in combination with dosed compression on the anterior abdominal wall, erosions can be detected in the form of small rounded elevations 1-3 mm in diameter with a small accumulation of contrast medium in the center.
- General blood test: with hidden or obvious gastrointestinal hemorrhages, iron deficiency anemia develops with characteristic laboratory signs:
- decrease in the content of red blood cells and hemoglobin;
- hypochromia of erythrocytes;
- low color index;
- anisocytosis, poikilocytosis;
- a decrease in the iron content in the blood.
- Analysis of feces for latent blood: with occult bleeding from erosions of the gastroduodenal region, the response to latent blood in the feces is positive.
- Examination of the secretory function of the stomach: the most commonly secretory function of the stomach is normal or elevated.
Survey program
- General analysis of blood, urine, feces.
- Analysis of feces for latent blood.
- FEGDS with biopsy of the gastric mucosa.
- Diagnosis of Helicobacter pylori infection.
- Study of the secretory function of the stomach.
- Biochemical blood test: determination of the blood content of iron, bilirubin, total protein and protein fractions, aminotransferases, urea, creatinine.
- X-ray examination of the stomach and duodenum
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