Raphael Michael, Patel Reena, Warren Bradley J
Gastroenterology Fellow, Providence Hospital, St John Health System, 16001 W 9 Mile Rd, Southfield, MI 48075-4818, USA.
J Am Osteopath Assoc. 2010 Dec;110(12):721-4.
The field of gastroenterology has had an abundance of technological advances in recent years, especially in the field of endoscopy. These advances are helpful to clinicians approaching gastrointestinal blood loss, especially in the small bowel. The authors report a case of a man who presented to the emergency department with obscure gastrointestinal blood loss. Results of an esophagogastroduodenoscopy and a colonoscopy suggested the source of the blood loss was within the small bowel. On an outpatient basis, the patient underwent video capsule endoscopy, which revealed scattered distal duodenal arteriovenous malformations. He then underwent oral double balloon endoscopy with ablation of the arteriovenous malformations, with no further bleeding or drop in hemoglobin. The authors review advances in small bowel imaging and endoscopy, including video capsule endoscopy, double balloon endoscopy, and computed tomography enterography. A comprehensive data review was conducted by searching the National Library of Medicine's PubMed database to identify recent published literature in the fields of radiology and gastroenterology. The authors apply these findings to the workup and diagnosis of obscure gastrointestinal blood loss.
近年来，胃肠病学领域取得了大量技术进步，尤其是在内镜检查领域。这些进展对处理胃肠道出血的临床医生很有帮助，特别是在小肠疾病方面。作者报告了一例因不明原因胃肠道出血而就诊于急诊科的男性病例。食管胃十二指肠镜检查和结肠镜检查结果提示出血源在小肠内。在门诊，患者接受了视频胶囊内镜检查，发现十二指肠远端散在动静脉畸形。随后，他接受了口服双气囊内镜检查并对动静脉畸形进行了消融治疗，之后未再出血，血红蛋白也未下降。作者回顾了小肠成像和内镜检查的进展，包括视频胶囊内镜、双气囊内镜和计算机断层扫描小肠造影。通过检索美国国立医学图书馆的PubMed数据库进行了全面的数据回顾，以确定放射学和胃肠病学领域最近发表的文献。作者将这些发现应用于不明原因胃肠道出血的检查和诊断。
