Diagnosis and treatment of small intestinal bleeding： Retrospective analysis of 76 cases

• Published in: World journal of gastroenterology : WJG Vol. 12; no. 45; pp. 7371 - 7374
• Main Author: Ba, Ming-Chen
• Format: Journal Article
• Language: English
• Published: United States Department of General Surgery,Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, Guangdong Province, China 07.12.2006; Baishideng Publishing Group Co., Limited
• Subjects: Adolescent; Adult; Aged; Female; Gastrointestinal Hemorrhage - diagnostic imaging; Gastrointestinal Hemorrhage - drug therapy; Gastrointestinal Hemorrhage - etiology; Hematuria - diagnosis; Hematuria - epidemiology; Humans; Intestinal Diseases - diagnosis; Intestinal Diseases - drug therapy; Intestinal Neoplasms - diagnosis; Intestinal Neoplasms - diagnostic imaging; Intestine, Small - blood supply; Male; Middle Aged; Rapid Communication; Retrospective Studies; Tomography, X-Ray Computed; Young Adult; 出血; 小肠; 憩室; 治疗方法; 瘤形成; Neoplasia; Small intestine; Hemorrhage; Meckel's diverticulum
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v12.i45.7371

AIM： To investigate the causes of small intestinal bleeding as well as its diagnosis and therapeutic approaches. METHODS： A retrospective analysis was conducted according to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years. RESULTS： In these patients, tumor was the most frequent cause of small intestinal bleeding （37/76）, followed by Meckel＇s diverticulum （21/76）, angiopathy （15/76） and ectopic pancreas （3/76）. Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by ^99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by exploratory laparotomy. Although all the patients received surgical treatment, most of them （68/76） received part enterectomy covering the diseased segment and enteroanastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications. CONCLUSION： Tumor is the major cause of small intestinal bleeding followed by Meckel＇s diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction angiography, ^99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examination of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleeding.