Kitiyakara Taya, Selby Warwick
Wycombe General Hospital, High Wycombe, Bucks, UK.
Gastrointest Endosc. 2005 Aug;62(2):234-8. doi: 10.1016/s0016-5107(05)00292-0.
Approximately two thirds of patients undergoing capsule endoscopy for obscure GI bleeding will have an abnormality found in the small intestine. This report describes 9 patients (4 men, 5 women) of 140 with obscure bleeding in whom a source of their blood loss was found in the stomach or the colon at capsule endoscopy.
A review was made of a prospective database of 140 consecutive patients undergoing capsule endoscopy for obscure GI bleeding at a single center. Patients with a definite or likely cause of bleeding within reach of conventional upper or lower GI endoscopy were identified.
Three patients had gastric antral vascular ectasia and another an inflamed pyloric canal polyp. Two patients had actively bleeding cecal carcinoma, missed at previous colonoscopies. Two others had bleeding cecal angiodysplasia. The final patient had severe nonspecific cecal inflammation. The identification of these lesions was aided by the suspected blood indicator. All patients underwent endoscopic therapy or surgery for their non-small-bowel lesions.
Like push enteroscopy, capsule endoscopy also can identify lesions within reach of conventional endoscopy and colonoscopy. These subsequently can be treated successfully. The reasons why these lesions have been missed are unclear.
因不明原因消化道出血接受胶囊内镜检查的患者中，约三分之二会在小肠发现异常。本报告描述了140例不明原因出血患者中的9例（4例男性，5例女性），这些患者在胶囊内镜检查时发现其失血来源在胃或结肠。
回顾了一个前瞻性数据库，该数据库包含在单一中心因不明原因消化道出血接受胶囊内镜检查的140例连续患者。确定了在传统上消化道或下消化道内镜检查范围内有明确或可能出血原因的患者。
3例患者有胃窦血管扩张，另1例有炎症性幽门管息肉。2例患者有活动性盲肠癌，之前的结肠镜检查未发现。另外2例有盲肠血管发育异常出血。最后1例患者有严重的非特异性盲肠炎症。可疑血液指标有助于这些病变的识别。所有患者均因非小肠病变接受了内镜治疗或手术。
与推进式小肠镜检查一样，胶囊内镜检查也能识别传统内镜检查和结肠镜检查范围内的病变。这些病变随后可以成功治疗。这些病变被漏诊的原因尚不清楚。
