MORPHOLOGICAL CHARACTERISTICS OF CHANGES IN THE PERIULCEROUS ZONE OF BLEEDING GASTRODUODENAL ULCERS DEPENDING ON THE DEGREE OF BLEEDING ACTIVITY ACCORDING TO FORREST

Abstract

Despite the signifi cant decrease in morbidity and mortality rates due to peptic ulcer disease of the stomach and duodenum over the past few decades, complications still occur in 10-20 % of patients. Of these, bleeding is the most common complication of peptic ulcers, with an average 30-day mortality of up to 8.6 %. The aim of the study was to evaluate histological changes in the periulcerous zone of active bleeding gastroduodenal ulcers in patients with diff erent degrees of activity of gastroduodenal bleeding according to Forrest. 378 patients with chronic bleeding ulcers of the stomach and duodenum (DPK) were evaluated endoscopically according to the Forrest classifi cation. There were 231 (61.11 %) patients with Forest IA, IB, IIA, IIB, IIS who underwent endoscopic hemostasis (injection therapy or argon plasma coagulation). In 147 (38.89 %) patients, hemostasis was not performed due to the endoscopic pattern of bleeding activity according to Forrest III. A biopsy was taken from the area of periulcerous infi ltrate during endoscopic diagnosis before hemostasis on the day of hospitalization. It has been established that endoscopic bleeding stigmata have morphological features depending on the severity of destructive, infl ammatory and regenerative changes in periulcer tissues. Microscopic analysis of biopsies of periulcerous infi ltrate in bleeding gastroduodenal ulcers allows predicting the probability of recurrence of bleeding.