Erosive and ulcerative lesions of gastrointestinal tract in patients with burns

Abstract

To analyze the incidence of erosive and ulcerative lesions of gastrointestinal tract in patients with burns, including those complicated by gastrointestinal bleeding, depending on severity of injury, complications of burn disease and treatment features. Medical records of 1833 patients were reviewed. We have retrospectively analyzed symptoms of disease and incidence of gastrointestinal bleeding depending on treatment strategy in patients with identified erosive and ulcerative lesions of gastrointestinal tract. Risk of gastrointestinal erosions and ulcers, including those complicated by gastrointestinal bleeding, correlates with area and depth of burn damage, especially in patients with thermo-inhalation injury and infectious complications of burn disease. Proton pump inhibitors intake in patients with burns of up to 50% of body surface area (BSA) and deep lesions up to 40% of BSA is followed by less incidence of gastrointestinal bleeding compared to H2-histamine receptor blockers. At the same time, severe burns of more than 50% of BSA ensure high risk of gastrointestinal bleeding regardless antisecretory therapy. Endoscopy upon admission is recommended in all patients with burns ≥30% of BSA or deep lesions ≥20% of BSA, as well as severe thermo-inhalation injury. This approach ensures timely diagnosis of gastrointestinal lesions and their adequate treatment.