Ağızdan, KUSMAYLA, KAHVE TELVESİ ŞEKLİNDE SİYAHA YAKIN REKTE kan gelmesine (hematemez) denir.
Mide kanamasının birçok sebebi var yani tatbikî buna biz sindirim sistemi kanaması diyoruz. Sindirim sistemi kanamaları dediğimiz zaman genelikle üst sindirim sistemi kanamaları anlaşılır.. Üst sindirim sistemi nedir? Yemek borusu ve midedir ve on iki parmak bağırsağına üst sindirim sistemi diyoruz. Kanamaların yüzde doksanı buradan olmaktadır bu bölgede de en çok kanamaya neden olan on iki parmak bağırsağı ülserleridir ve mide ülserleridir. Üst kanamaların yani mide, yemek borusu ve on iki parmak bağırsağı kanamalarının yüzde ellisini ülser hastalığı yani peptik ülser hastalığı oluşturur. Ülserlerde en sık on iki parmak bağırsağında görülmektedir. Demek ki bir hasta mide kanamasıyla geldiği zaman biz olayın en az yüzde elli sebebini on iki parmak bağırsağı ve mideye ait ülserlerin olduğunu düşüneceğiz. Ama bunun dışında gastritler mide kanaması yapabilir, midedeki damarsal bir patolojiler yani doğuştan olsun sonradan meydana gelsin bunlar yapabilir. Mide tümörleri çok nadir de olsa kanamanın sebebi olabilir. Burada tabi mide kanamasıyla gelen bir hastada en önemli sorgulamamız gereken şeylerden birisi hastanın mide rahatsızlığının olup olmadığı da daha önceden ve bu mide rahatsızlığının ne zamandan beri olduğu son zamanda herhangi bir ilaç kullanıp kullanmadığı, örneğin hastada bir gastrit durumu vardır veya sessiz bir ülser vardır hasta anestezi almıştır, ağrı kesici almıştır, romatizmal ilaç almıştır, antibiyotik almıştır birtakım ilaçlar almıştır bunlar sessiz duran bu ülserleri aktive
ederek kanamaya sebep olabilmektedir.
Diğer
Mide kanamalarının en sık sebebi mide içerisinde veya midenin hemen çıkışında , ince bağırsağın başlangıcında oluşan ülserler yani yaralar nedeniyledir. Bunları ameliyat ile değil, genellikle endoskopik yöntemlerle tedavi edebiliyoruz. Ülserler dışında daha az olmakla beraber, bazen de temiz kanı taşıyan küçük damarlarda çatlamalar olup buradan kamalar olabilir. Ayrıca kronik karaciğer hastalığı nedeniyle mide içerisinde kirli kanı taşıyan damarlarda genişlemeler olabilir. Bu genişlemelere varis diyoruz. Mide içindeki bu varisler de kanayabilir. Bunların da büyük oranla endoskopik tedavisi mümkündür. Nadiren, endoskopik tedavilerle tedavi edemeyip ameliyat ettiğimiz hastalar da bulunmaktadır. Ama ilk olarak endoskopik tedaviler yapmayı tercih ederiz.
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