NOT EVERY PRESSURE ULCER IS A LIKE PRESSURE SORE - THE RISK OF MDRPU
| Authors | |
|---|---|
| Year of publication | 2023 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Introduction: Pressure sores represent a major health issue worldwide and their treatment is very expensive. The formation of a pressure sore leads to ischemia and necrosis. In addition to classic pressure ulcers located on the skin, pressure ulcers occurring on organs can also be encountered in practice. Methods: Percutaneous endoscopic gastrostomy is used for long-term enteral nutrition. The most common indication is swallowing disorder. If the patient starts swallowing, we can easily close the canal soon after insertion of the feeding tube and it heals completely in a few days. The method is relatively safe with low mortality. We experienced a very unusual complication in the patient after the resumption of the swallowing act. After 12 months following the introduction of PEG, a pressure ulcer formed in the wall of the aorta as a result of prolonged pressure of the gastrostomy probe with subsequent bleeding into the gastrointestinal tract. This condition was caused by the anatomical conditions of the patient, because the rest of the probe got stuck in the duodenal diverticulum and failed to be spontaneously eliminated. Long-term pressure on the aorta caused necrosis of the arterial wall with subsequent development of aneurysm. Results: The treatment of this patient included removing the remaining part of the PEG with following implantation of a stent in the abdominal aorta. One year after the therapy, the patient is bleeding-free and the stent is freely passable. The second patient was a woman with chronic constipation who was admitted for acute symptoms of intestinal obstruction. The hard stool in the intestine by its prolonged pressure had created a pressure ulcer on another branch of the intestine. The treatment of the patient with intestinal defect included resection of the bowel with decubitus ulcer and suture and cretion of a temporary stoma. Conclusions: Pressure sores arise from long-term pressure on the tissue. This fact must always be kept in mind when treating the patient. Prevention of and proper management of complications are critical to ensuring successful outcome. |