Zhang Bing-Ling, Chen Chun-Xrao, Li You-Ming
Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Turk J Gastroenterol. 2012 Jun;23(3):220-5. doi: 10.4318/tjg.2012.0338.
BACKGROUND/AIMS: We aimed to investigate the diagnostic applications of capsule endoscopy examination patients in obscure gastrointestinal bleeding and to analyze the etiology of obscure gastrointestinal bleeding in patients of different ages.
A total of 385 patients with obscure gastrointestinal bleeding, aged 17-91 years, were assigned into three groups as: elderly (>65 years), middle-aged (41-65 years) and young adults (17-40 years). Gastrointestinal examinations were carried out in each participant with the use of a capsule endoscopy diagnostic system.
Overall, the detection rates for positive capsule endoscopy findings in the elderly, middle-aged and young adult groups were 66.94%, 62.29% and 61.80%, respectively, and the diagnostic rates were 48.76%, 45.14% and 53.93%, respectively. No significant difference existed in either rate between the different age groups. The commonest pathological changes detected were vascular malformations, intestinal tumors, Crohn’s disease, non-specific enteritis, and small intestine ulcer, but the distribution of these causes for obscure gastrointestinal bleeding varied between the different age groups. The top three common reasons for obscure gastrointestinal bleeding in the elderly group were vascular malformations, small intestine ulcers and small intestine tumors, while in the middle-aged group vascular malformation, small intestine tumor and non-specific enteritis were the most common. The young adults were most likely to have Crohn’s disease, small intestine tumors or non-specific enteritis.
Capsule endoscopy examination not only shows potential diagnostic value for obscure gastrointestinal bleeding, but it also helps to identify the leading causes of obscure gastrointestinal bleeding in all age groups.
背景/目的:我们旨在研究胶囊内镜检查在不明原因消化道出血患者中的诊断应用,并分析不同年龄段不明原因消化道出血患者的病因。
共有385例年龄在17至91岁之间的不明原因消化道出血患者被分为三组:老年组(>65岁)、中年组(41至65岁)和青年组(17至40岁)。使用胶囊内镜诊断系统对每位参与者进行胃肠道检查。
总体而言,老年组、中年组和青年组胶囊内镜检查阳性发现率分别为66.94%、62.29%和61.80%,诊断率分别为48.76%、45.14%和53.93%。不同年龄组之间的这两个率均无显著差异。检测到的最常见病理变化为血管畸形、肠道肿瘤、克罗恩病、非特异性肠炎和小肠溃疡,但这些不明原因消化道出血病因在不同年龄组中的分布有所不同。老年组不明原因消化道出血的前三大常见原因是血管畸形、小肠溃疡和小肠肿瘤,而中年组中血管畸形、小肠肿瘤和非特异性肠炎最为常见。青年组最易患克罗恩病、小肠肿瘤或非特异性肠炎。
胶囊内镜检查不仅对不明原因消化道出血具有潜在诊断价值,而且有助于确定各年龄组不明原因消化道出血的主要病因。