Abstract
The aim. To evaluate the effectiveness of X-ray interventions in arosive bleeding in patients with complicated duodenal ulcer.
 Materials and methods. X-ray endovascular interventions were used in 8 patients who developed arosive bleeding as a complication of duodenal ulcer. All patients with signs of gastrointestinal bleeding were examined according to clinical protocols. Hemodynamically stable patients underwent X-ray endovascular interventions.
 Results and discussion. In the near future, bleeding stopped in all 8 (100 %, OR–0.04 [0.005–0.29], p=0.03) patients. On day 2, two patients who underwent embolization of their own hepatic artery had a recurrence of bleeding (0.56 [0.065–4.76], p=0.29). Repeated angiography and embolization attempts were ineffective, and both patients died. In patients who underwent gastroduodenal and pancreatouodenal artery embolization, bleeding did not resume. Thus, we obtained good results as 6 out of 8 patients recovered (75 %), despite the severity of their condition and a disappointing prognosis (OR–9.0 [1.0–46.7], p <0.05).
 Conclusions. Adherence to the tactics mentioned above in the treatment of bleeding in duodenal ulcer was highly effective, especially in superselective embolization with the detection of bleeding gel. If the presence of arosive bleeding is confirmed, emergency surgical treatment with suturing of the damaged vessel is shown in hemodynamically unstable patients, and endovascular intervention is possible in hemodynamically stable patients. Further studies are needed to determine the criteria for a high risk of arosive bleeding developing in patients with complicated duodenal ulcer as well as to prevent its occurrence through the use of X-ray endovascular interventions.
Highlights
The prevalence of duodenal ulcer among the general population is 5–10 %; the disease is verified with a frequency of 0.1–0.3 % per year
Materials and methods of the research The results of surgical treatment of complicated duodenal ulcer are presented according to the materials of the surgical department of the Kyiv Regional Clinical Hospital
X-ray endovascular intervention was used in the treatment of 8 patients with complicated duodenal ulcer who developed arosive bleeding
Summary
The prevalence of duodenal ulcer among the general population is 5–10 %; the disease is verified with a frequency of 0.1–0.3 % per year. Complications of peptic ulcer disease, such as perforation and bleeding, have a significant economic impact. The total cost of peptic ulcer treatment in the United States, which includes both direct costs and loss of productivity, is estimated at $ 5.65 billion per year [3]. Acute bleeding from the (2021), «EUREKA: Health Sciences» Number 2 upper gastrointestinal tract accounts for > 400,000 hospitalizations per year in the United States [4]. According to other statistical studies, in the European Union, the cost of bleeding, perforation or a combination of them per person is 12,000, 19,000 and 26,000 euros per patient respectively [5]
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