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Objective To analyze the feasibility and the diagnostic yield of double-balloon enteroscopy (DBE) examinations for small bowel bleeding (SBB). Methods A retrospective analysis was conducted on 52 cases with small bowel bleeding between June 2015 and July 2016,and all was treated with DBE. therapeutic outcome, complications and follow-up were compared. Results The study included 52 patients (28 males and 24 females) with an average age of (51.0 ± 17.0) years (16~82 years) and onset time (8.3 ± 4.0) days (1~14 days) . 25 using oral route and 21 using the anal route, 1 using the colon ifstula route, a combination of using oral and anal (n=4).The bleeding source was identiifed in 40 of 52 patients (76.9%), complication rate was 5.8%(3/52), and rebleeding rate was 16.7%(2/12). The endoscopic treatments included polypectomies (n=5), argon plasma coagulation (APC, n=2), surgical treatment (n=14, 26.9%), and foreign-body extraction (n=1). Patients were diagnosed with the following:tumors (n=9, 17.3%), ulcers (n=9, 17.3%), Crohn’s disease (n=7, 13.5%), polyps (n=5, 9.6%), diverticulum (n=4, 7.7%). Patients with small bowel bleeding were followed up for a mean period of (8.3±2.0) months (range 4~10 months), 2 deaths were dying from small bowel cancer. Conclusions DBE is a safe endoscopic technique for patients with small bowel bleeding and can be safely carried out even after Roux-en-Y operation. Tumors, ulcers and Crohn’s disease are very common causes of SBB. The rebleeding rate after a negative DBE is considerable, especially small bowel vascular lesions.
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Objective To evaluate the methodology, feasibility, safety and efficacy of cap-assisted endoscopic sclerotherapy(CAES)for hemorrhoids. Methods Patients with grade Ⅰ to Ⅲ internal hemorrhoids underwent CAES from September 2014 to May 2016. According to the methodology of CAES, reasons for blooding were identified and polypectomy and excision of anal papilla fibroma was performed. Efficacy,intraoperative and postoperative complications and patient satisfaction were evaluated during and after CAES. The follow-up was more than three months. Results A total of 48 patients with gradeⅠ toⅢinternal hemorrhoids underwent CAES,including 25(52.1%)patients with grade Ⅰ,21(43.8%)patients with grade Ⅱ,and 2(4.2%)grade Ⅲ. During the whole procedure of CAES, colon and terminal ileum examination was performed in 48(100.0%)patients, polypectomy was performed in 14(29.2%)patients, excision of anal papilla fibroma was performed in 1(2.1%)patient, excision of external hemorrhoids was performed in 1(2.1%)patient,biopsy for the polyps on dentate line was performed in 2(4.2%)patients, and sclerotherapy for rectal mucosal prolapse was performed in 2(4.2%)patients. No bleeding was observed during and after CAES. Infection occurred in one(2.1%)patient, who recovered with a one-week anti-infective therapy. One(2.1%)patient claimed mild tenesmus within four days after CAES.No complications were observed within the three-month follow-up. All patients(100.0%)were satisfied with this novel procedure. Conclusion CAES, as a novel endoscopic sclerotherapy, is a safe and effective endoscopic therapy with high patient satisfaction for internal hemorrhoids.
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Objective To investigate the clinical situation of inflammatory bowel disease (IBD).Methods The clinical features and treatment features of 122 patients with IBD were investigated.Results In 122 IBD patients,54 cases had ulcerative colitis (UC),the lesion was in colon,hospital number visited was median 3,the ratios of using amino salicylic acid salts,hormones,immunosuppressive agents,biological agents and antibiotics was 100.0％ (54/54),55.6％ (30/54),24.1％ (13/54),7.4％ (4/54) and 75.9％ (41/54); 68 cases had Crohn disease (CD),the lesion was in the ileocolic,hospital number visited was median 4,the ratios of using amino salicylic acid salts,hormones,immunosuppressive agents,biological agents and antibiotics was 95.6％ (65/68),58.8％ (40/68),47.1％ (32/68),11.8％ (8/68) and 79.4％ (54/68).The uses of CD in patients with immunosuppression,quinolone antibiotics in patients of CD were higher than those of patients with UC,the use of herbal medicine in patients of CD was lower than that in patients of UC,the difference was statistically significant (P ＜ 0.05).Conclusion The main drugs currently used to treat IBD are amino salicylic acid preparation,corticosteroids,immunosuppressive agents,biological agents.