Erosive and ulcerative lesions of the gastrointestinal tract and bleeding in patients with critical lower limb ischemia and diabetes mellitus underwent endovascular interventions

The objective was to study the prevalence of erosive and ulcerative gastroduodenal lesions, bleedings of this localization and the relationship with factors predisposing to them in patients with critical lower limb ischemia and type 2 diabetes mellitus who underwent endovascular intervention for limb revascularization.

Methods and materials. The study included 81 patients aged 67.5±6.8 years, hospitalized in the department of vascular surgery with critical lower limb ischemia of atherosclerotic genesis and type 2 diabetes mellitus to perform revascularization by means of transluminal balloon angioplasty with stenting when indicated. In the preoperative period, all patients underwent fibrogastroduodenoscopy, according to the results of which a scoring assessment of the lesion of the gastric mucosa and duodenum was presented.

Results. All patients participating in the study were diagnosed with pathology of the gastroduodenal zone: in 95.1 % of the inflammatory nature, in 4.9 % of the ulcer. The relationship between the duration of rest pain, the fact of damage to the mucous membrane of the upper gastrointestinal tract and its severity was not revealed, but the relationship of erosive and ulcerative lesions of the stomach and duodenum with the number of taken pain pills was determined. In patients with repeated endovascular intervention and / or amputation, gastrointestinal bleedings were more often recorded compared with study participants who underwent a single revascularization – 11.1 and 1.6 % of patients, respectively.

Conclusion. Erosive and ulcerative lesions of varying severity are present in all patients with critical lower limb ischemia on the background of diabetes mellitus. At the same time, patients with repeated endovascular interventions and / or amputations are more susceptible to bleeding. For the prevention of pathology of the stomach and duodenum, an in-depth diagnosis and a differentiated approach are required.

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