Desa L A, Ohri S K, Hutton K A, Lee H, Spencer J
Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Br J Surg. 1991 Feb;78(2):192-5. doi: 10.1002/bjs.1800780219.
Intraoperative enteroscopy was performed in 12 patients (median age 68 years) with obscure gastrointestinal bleeding probably of small bowel origin, six of whom were men. All the patients were evaluated by routine haematological, coagulation and biochemical profiles, upper and lower gastrointestinal endoscopies, visceral angiography and/or isotope scanning. All the patients were anaemic. Visceral angiography was useful on three of the 12 occasions on which it was used and isotope scanning was valuable on eight of the 11 occasions it was used. Nine patients had undergone previous laparotomy. Enteroscopy was performed successfully in all cases, with fresh blood and discrete vascular lesions being the chief findings (10 of 12 cases). Segmental resections (n = 8) and local resections (n = 2) were performed in ten patients, with two patients having more than one laparotomy for rebleeding. Five patients developed postoperative complications and there was an operative death and one late death. Three of the ten surviving patients experienced further rebleeding. Intraoperative enteroscopy is now an essential adjunct to laparotomy for gastrointestinal bleeding which has been localized to the small bowel before operation.
对12例（中位年龄68岁）可能源于小肠的不明原因胃肠道出血患者进行了术中肠镜检查，其中6例为男性。所有患者均接受了常规血液学、凝血和生化检查、上消化道和下消化道内镜检查、内脏血管造影和/或同位素扫描。所有患者均贫血。内脏血管造影在12次检查中有3次有用，同位素扫描在11次检查中有8次有价值。9例患者曾接受过剖腹手术。所有病例的肠镜检查均成功完成，主要发现为新鲜血液和散在的血管病变（12例中的10例）。10例患者进行了节段性切除（n = 8）和局部切除（n = 2），2例患者因再次出血接受了不止一次剖腹手术。5例患者出现术后并发症，有1例手术死亡和1例晚期死亡。10例存活患者中有3例再次出血。术中肠镜检查现已成为术前已定位至小肠的胃肠道出血剖腹手术的重要辅助手段。
