Setya V, Singer J A, Minken S L
Department of Surgery, St. Agnes Hospital, Baltimore, Maryland 21229.
Am Surg. 1992 May;58(5):295-9.
A 7-year experience involving 12 cases of massive, unrelenting lower gastrointestinal hemorrhage is presented. In these patients, the bleeding could not be localized by multiple diagnostic modalities and was managed by blind subtotal colectomy. While the procedure was efficacious in arresting bleeding in all cases, a resultant mortality of four cases (33%) ensued. Morbidity among the survivors was significant. Only three patients (25%) survived without complications, which enabled an early discharge from the hospital. Diverticulosis was the most common cause (83%) of uncontrollable and preoperatively undiagnosed bleeding in this group of patients. These 12 cases of blind subtotal colectomy for massive lower gastrointestinal bleeding represent one of the larger series in the literature. These data are consistent with more recent reports that indicate that subtotal colectomy for lower gastrointestinal bleeding is an effective but a formidable procedure. This is contrary to the earlier published results.
本文介绍了一项为期7年、涉及12例严重、持续性下消化道出血的病例。在这些患者中，通过多种诊断方式均无法定位出血部位，最终通过盲法次全结肠切除术进行治疗。虽然该手术在所有病例中均有效地止住了出血，但仍有4例（33%）患者死亡。幸存者的发病率也很高。只有3例（25%）患者存活且无并发症，得以早期出院。憩室病是这组患者无法控制且术前未诊断出的出血的最常见原因（83%）。这12例因大量下消化道出血而行盲法次全结肠切除术的病例是文献中较大的系列病例之一。这些数据与最近的报告一致，表明下消化道出血的次全结肠切除术是一种有效的但具有挑战性的手术。这与早期发表的结果相反。
