Kovacs Donald J, Berk Ted
Carlisle Regional Medical Center, Carlisle, PA USA.
J Am Board Fam Med. 2006 Nov-Dec;19(6):641-2. doi: 10.3122/jabfm.19.6.641.
The term gastrointestinal bleeding of obscure origin is used to describe bleeding of unknown origin that persists or recurs after a negative initial esophagogastroduodenoscopy and colonoscopy. We report the case of a middle-aged woman with gastrointestinal bleeding of obscure origin who had 9 stool specimens that tested negative for occult blood but was found to have adenocarcinoma of the distal duodenum on capsule endoscopy. This case illustrates that, in the presence of unexplained iron-deficiency anemia, multiple negative fecal occult blood tests do not exclude the presence of GI blood loss, and that capsule endoscopy is a valuable diagnostic study in this context.
不明原因的胃肠道出血这一术语用于描述在初次食管胃十二指肠镜检查和结肠镜检查结果为阴性后仍持续或复发的不明原因出血。我们报告了一例不明原因胃肠道出血的中年女性病例，该患者9次粪便潜血试验均为阴性，但胶囊内镜检查发现十二指肠远端腺癌。该病例表明，在存在无法解释的缺铁性贫血时，多次粪便潜血试验阴性并不能排除胃肠道失血的存在，且在此情况下胶囊内镜检查是一项有价值的诊断研究。
