López Pardo Rafael, Mira Vázquez Angélica, Cuevas del Pino Delia, Toral Guinea Pablo, Krasniqui Gazmend
Servicio de Cirugía General y Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España.
Cir Esp. 2007 Nov;82(5):301-4. doi: 10.1016/s0009-739x(07)71729-3.
Gastrointestinal bleeding is considered to be obscure when routine endoscopic techniques (esophagogastroscopy and colonoscopy) fail to identify the origin of the hemorrhage. These hemorrhages represent 5% of all gastrointestinal bleeding. Twenty-seven percent of these hemorrhages are due to small bowel disease and gastrointestinal stromal tumors (GIST) are a frequent cause, especially in middle-aged patients. We present three cases that illustrate the difficulty of diagnosing this clinical entity. We emphasize the use of minimally invasive techniques such as computed tomography and laparoscopic surgery in the complicated management of these patients. We believe that the use of these techniques could avoid the need for other more aggressive procedures and allow the application of early definitive surgical treatment with the advantages of laparoscopic surgery.
当常规内镜检查技术（食管胃镜检查和结肠镜检查）未能确定出血来源时，胃肠道出血被认为是隐匿性的。这些出血占所有胃肠道出血的5%。其中27%的出血是由小肠疾病引起的，胃肠道间质瘤（GIST）是常见原因，尤其在中年患者中。我们介绍三例病例，以说明诊断这一临床实体的困难。我们强调在这些患者的复杂管理中使用计算机断层扫描和腹腔镜手术等微创技术。我们认为，使用这些技术可以避免其他更激进的手术，并且能够在腹腔镜手术优势的支持下进行早期确定性手术治疗。
