Renzulli P, Candinas D, Seiler C A
Klinik für Viszerale und Transplantationschirurgie, Inselspital, Universität Bern, Bern.
Ther Umsch. 2006 May;63(5):311-9. doi: 10.1024/0040-5930.63.5.311.
Gastrointestinal bleeding with its point of origin outside the reach of conventional gastro- and colonoscopy represents an extraordinary diagnostic and therapeutic challenge. Bleeding may originate from the small bowel distal to the duodenojejunal junction (middle gastrointestinal bleeding) or from the biliary tree (haemobilia) or from the pancreatic ductal system (haemosuccus pancreaticus). This particular type of gastrointestinal bleeding is often intermittend and caused by a variety of different pathologies. Angiography is the diagnostic method of choice for further investigation. It allows precise localization of the bleeding site and simultaneous interventional therapy (embolization/coiling). The importance of further diagnostic modalities such as scintigraphy, capsule endoscopy, push-enteroscopy and double-balloon-enteroscopy is discussed.
起源于传统胃镜和结肠镜检查范围之外的胃肠道出血是一项特殊的诊断和治疗挑战。出血可能源于十二指肠空肠交界处远端的小肠（中消化道出血）、胆道系统（胆道出血）或胰腺导管系统（胰管出血）。这种特殊类型的胃肠道出血通常是间歇性的，由多种不同病理情况引起。血管造影是进一步检查的首选诊断方法。它能够精确确定出血部位并同时进行介入治疗（栓塞/弹簧圈栓塞）。文中还讨论了闪烁扫描、胶囊内镜、推进式小肠镜和双气囊小肠镜等其他诊断方法的重要性。
