ABSTRACT
Resumen Actualmente, se pueden identificar lesiones del intestino delgado que antes eran inaccesibles. La principal herramienta diagnóstica es la videocápsula endoscópica por el alto valor predictivo negativo. Con los avances en los métodos endoscópicos, la clasificación del sangrado gastrointestinal ha cambiado. Es así como la definición del sangrado oscuro, que antes incluía al originado en el intestino delgado, se ha relegado cuando su origen no se puede identificar tras la realización de una esofagogastroduodenoscopia, colonoscopia y estudios del tracto digestivo medio, tales como videocápsula endoscópica, enteroscopia de empuje, enteroscopia profunda, enteroscopia intraoperatoria, enterorresonancia, enterotomografía, angiografía y gammagrafía.
Abstract Intestinal lesions that were previously inaccessible can now be identified. The most important new diagnostic tool is the endoscopic videocapsule because of its high negative predictive value. With advances in endoscopic methods, the classification of gastrointestinal bleeding has changed so that definition of occult and obscure bleeding that previously included bleeding originating in the small intestine has been relegated to cases for which the origin cannot be identified after performing esophagogastroduodenoscopy, colonoscopy and studies of the middle digestive tract such as endoscopic videocapsule, push enteroscopy, deep enteroscopy , intraoperative enteroscopy, MRI enterography, CT enterography, angiography and scintigraphy.
Subject(s)
Capsule Endoscopes , Intestine, Small/abnormalities , AngiographyABSTRACT
Objective:To analyze and discuss etiology and diagnosis of small intestinal hemorrhage.Methods:Fifty-four cases, who had small intestinal hemorrhage and had been admitted in our hospital from 1980.1 to 2003.12,were analyzed according to etiology and diagnosis.Results:Small intestinal tumors were found in 35 cases(64.81%),among which most were malignant (68.57%),angiodysplasia in 10 cases (18.52%),Crohn's disease,infective disease and diverticula in 9 cases (16.67%).The positive rates of intraoperative colonoscopy,angiography,radionucleide scanning,endoscopy,intestinal tract X-ray as well as ultrasound were 6/6(100%),4/5(80%),5/6(83.33%),8/37(21.62%),6/24(25.00%) and 10/29(34.48%) respectively.Conclusion:Tumor is the most common cause of small intestinal hemorrhage and angiodysplasia often cause small intestinal massive bleeding.Besides intraoperative colonoscopy,angiography and radionucleide scanning special diagnostic methods.B ultrasound is helpful for diagnosis of small intestinal hemorrhage.