{"id":4055,"date":"2019-07-04T18:25:57","date_gmt":"2019-07-04T18:25:57","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/hda-por-malformacao-vascular-em-delgado-proximal\/"},"modified":"2022-06-17T13:55:51","modified_gmt":"2022-06-17T13:55:51","slug":"hda-por-malformacao-vascular-em-delgado-proximal","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/hda-por-malformacao-vascular-em-delgado-proximal\/","title":{"rendered":"Hemorragia Digestiva Alta: Exame e Terap\u00eautica Endosc\u00f3pica Underwater"},"content":{"rendered":"

Paciente masculino, 82 anos, com IRC dial\u00edtica, AVC pr\u00e9vio em uso de clopidogrel 75mg\/dia, com quadro de melena h\u00e1 3 dias, acompanhado de adinamia intensa. Investiga\u00e7\u00e3o laboratorial mostrou hemoglobina de 5.3 mg\/dL, necessitando de hemotransfus\u00e3o.<\/p>\n

Realizada endoscopia digestiva alta que evidenciou sangramento ativo em duodeno distal. Foto abaixo:<\/p>\n

\"\"<\/a><\/p>\n

Pela intensidade do sangramento ativo houve dificuldade de identificar o foco exato do sangramento. Dessa forma, optado por realizar o exame com preenchimento do \u00f3rg\u00e3o com \u00e1gua. Fotos abaixo:<\/p>\n

\"\"<\/a> \"\"<\/a><\/p>\n

\"\"<\/a> \"\"<\/a><\/p>\n

\"\"<\/a> \"\"<\/a><\/p>\n

\"\"<\/a> \"\"<\/a> \"\"<\/a><\/p>\n

Sendo ent\u00e3o observado uma malforma\u00e7\u00e3o vascular com sangramento ativo. Optado pela realiza\u00e7\u00e3o de inje\u00e7\u00e3o underwater<\/em> de solu\u00e7\u00e3o de adrenalina (1:10.000UI), com parada do sangramento. Fotos abaixo:<\/p>\n

\"\"<\/a> \"\"<\/a> \"\"<\/a> \"\"<\/a><\/p>\n

E em seguida realizada a coloca\u00e7\u00e3o de 2 clipes hemost\u00e1ticos:<\/p>\n

\"\"<\/a> \"\"<\/a> \"\"<\/a> \"\"<\/a> \"\"<\/a> \"\"<\/a><\/p>\n

Paciente evoluiu bem, recebendo alta ap\u00f3s 2 dias, sem novos epis\u00f3dios de sangramento em acompanhamento ambulatorial de 1 m\u00eas.<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Paciente masculino, 82 anos, com IRC dial\u00edtica, AVC pr\u00e9vio em uso de clopidogrel 75mg\/dia,…<\/p>\n","protected":false},"author":3495,"featured_media":4037,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[150],"tags":[],"ano":[145],"tipo":[153,157],"volume":[147],"class_list":["post-4055","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casosclinicos","ano-145","tipo-endoscopia-digestiva-alta","tipo-intestino-delgado","volume-volume-ii"],"yoast_head":"\nHemorragia Digestiva Alta: Exame e Terap\u00eautica Endosc\u00f3pica Underwater • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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