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Khirurgii

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Year 2017 Vol. 25 No 1

REVIEWS

I.N. KLIMOVICH, S.S. MASKIN, P.V. ABRAMOV

PATHOGENESIS OF INTESTINAL INSUFFICIENCY SYNDROME IN UPPER GASTROINTESTINAL TRACT BLEEDINGS

FSBEE HE "Volgograd State Medical University" of the Ministry of Health of Russia
Volgograd,
The Russia Federation

The intestinal insufficiency syndrome (IIS) is accompanied by severe gastrointestinal bleeding (GIB) from the upper gastrointestinal tract. Acute massive blood loss causes blood circulation centralization, as the main protective and compensatory reaction of the organism, which saves from immediate destruction the brain highly sensitive to hypoxia, but it damages internal organs and especially the intestines, as a shock body. Intestinal hypoxia leads to massive epithelial mucous destruction with exposing the submucosa. Due to the elevated permeability of the intestinal wall barriers, potentiation of the systemic endotoxicosis occurs by the hydrolysis products of the blood streamed into the intestinal lumen and effect of vital activity products of allochthonous microflora manifested the initial stage of multiple organ failure.
At present, some issues of pathogenesis violations of the «barrier» function of the intestinal wall in case of IIS still remain insufficiently studied, including features of microvascular circulation and its regulation in the intestinal wall caused the intestinal critical oxygen dependence even in minor hemorrhagic hypotension, against sufficient ensuring with oxygen of other organs; mechanisms of the ischemic and especially of the reperfusion injury of the intestinal wall. All this dictates the need for further experimental and clinical studies, the results of which will serve as a basis for the development of new treatment methods of intestinal insufficiency syndrome.

Keywords: intestinal insufficiency syndrome, gastrointestinal bleeding, ischemia-reperfusion, intestinal wall, «barrier» function, allochthonous microflora, hemorrhagic hypotension
p. 71-77 of the original issue
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Address for correspondence:
400131, the Russian Federation,
Volgograd, Pavshikh Bortsov sg 1,
FGBOU IN «Volgograd State
Medical University»
Department of Hospital Surgery.
Tel.: 8 905 336-23-69
E-mail: klimovichigor1122@yandex.ru
Igor N. Klimovich
Information about the authors:
Klimovich I.N. MD, Ass. Professor of hospital surgery department, FSBEE HE "Volgograd State Medical University".
Maskin S.S. MD, Professor, Head of hospital surgery department, FSBEE HE "Volgograd State Medical University".
Abramov P.V. Post-graduate student of hospital surgery department, FSBEE HE "Volgograd State Medical University".
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