Esophageal Hemorrhagic Syndromes

Esophageal  bleeding is  one of  the most  common medical emergencies. It takes  the  3rd place among  all digestive hemorrhages, and accounts for 14–16 % among all gastrointestinal bleeding. The most common cause of esophageal hemorrhages is Mallory – Weiss esophageal tear (10–12 %), less often – varicose veins of the esophagus in portal hypertension syndrome (up to 4 %) and, in some cases, is esophagitis of various etiologies (up to 1.6 %). The problem of  esophageal  bleeding  is  characterized  by  high  incidence,  high  mortality  rate  due  to  constant  increase  of  portal hyper tension cases, recurrences, difficulties in diagnosis, anatomical and physiological features of the esophagus, low efficiency of the main methods of hemostasis. There are various surgical and conservative methods of hemostasis, which show a variety of opinions in the solution to the problem of stopping esophageal bleeding. In Mallory – Weiss syndrome, endoscopic hemostasis is considered to be the preferred method of treatment. Management of portal hypertension is the most difficult task; a wide range of operations is used from the minimally invasive operations to the liver transplantation, as well as endoscopic hemostasis (ligation, sclerotherapy). In esophageal bleeding, due to reflux esophagitis, mainly conservative treatment is suggested, operations are performed with recurrences or complications. Each kind of esophageal hemorrhage is considered as a separate problem.