Cheng F Y, Li X H, Zhang G Y
Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008.
Hunan Yi Ke Da Xue Xue Bao. 2001 Feb 28;26(1):70-2.
To explore the etiology and different methods of diagnosis for 33 cases of small intestinal hemorrhage, which were confirmed by surgery and/or pathology.
33 cases of small intestinal hemorrhage were diagnosed by endoscopy, barium studies, radionucleotide scanning, angiograpy, exploratory laparotomy and intraoperative colonscopy, which were confirmed by surgery and/or pathology.
Small intestinal tumors were found in 13 cases (39.39%), Leiomyoma in 8; infectious diseases in 8(24.24%); Meckel's diverticulum in 7(21.21%); and vascular malformation in 3(9.1%) and others in 2(6.06%). Among them, black stool (42.42%) is the most commonly seen. The common clinical presentation was middle-anemia and patients with unexplained abdominal pain (36.36%). Radionucleotide scanning was positive in 5 out of 7 cases, and all of five were Meckel's diverticulum. Endoscopy revealed 5 out of 20 cases. Exploratory laparotomy was performed in 6, 3 were found to have some lesions, and the other 3 were diagnosed by intraoperative colonscopy.
Tumor is the nost common cause of small intestinal hemorrhage, mied anemia and black stool are the common clinical presentations, Radionucleotide scanning is one of the most useful diagnostic methods for Meckel's diverticulum and intraoperative colonscopy could elevate veracity of diagnosis.
为探讨33例经手术和/或病理证实的小肠出血的病因及不同诊断方法。
对33例小肠出血患者采用内镜检查、钡剂造影、放射性核素扫描、血管造影、剖腹探查及术中结肠镜检查进行诊断，均经手术和/或病理证实。
发现小肠肿瘤13例（39.39%），其中平滑肌瘤8例；传染病8例（24.24%）；梅克尔憩室7例（21.21%）；血管畸形3例（9.1%），其他2例（6.06%）。其中，黑便（42.42%）最为常见。常见临床表现为中度贫血及不明原因腹痛的患者（36.36%）。7例放射性核素扫描中有5例阳性，5例均为梅克尔憩室。内镜检查20例中有5例发现病变。6例行剖腹探查，3例发现有病变，另3例通过术中结肠镜检查确诊。
肿瘤是小肠出血最常见的原因，混合性贫血和黑便是常见的临床表现，放射性核素扫描是诊断梅克尔憩室最有用的诊断方法之一，术中结肠镜检查可提高诊断准确性。
