Kim Bong Sik Matthew, Li Bob T, Engel Alexander, Samra Jaswinder S, Clarke Stephen, Norton Ian D, Li Angela E
Bong Sik Matthew Kim, Ian D Norton, Department of Gastroenterology, Royal North Shore Hospital, St Leonards NSW 2065, Sydney, Australia.
World J Gastrointest Pathophysiol. 2014 Nov 15;5(4):467-78. doi: 10.4291/wjgp.v5.i4.467.
Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.
胃肠道出血是急诊科和基层医疗环境中常见的问题。急性或显性胃肠道出血表现为呕血、黑便或便血。慢性或隐匿性胃肠道出血患者通常并无明显症状,通常表现为粪便潜血阳性或缺铁性贫血。不明原因胃肠道出血是指上消化道内镜检查和结肠镜检查评估后仍未明确出血源的反复出血,通常来自小肠。准确的临床诊断至关重要,可为确定性检查和干预提供指导。本综述总结了胃肠道出血的总体诊断方法,并为临床医生提供了实用指南。