Pasha Shabana F, Leighton Jonathan A
a Division of Gastroenterology and Hepatology , Mayo Clinic Arizona , Scottsdale , AZ , USA.
Expert Rev Gastroenterol Hepatol. 2016 Nov;10(11):1235-1244. doi: 10.1080/17474124.2016.1207525. Epub 2016 Jul 7.
Detection of small bowel (SB) bleeding remains a challenge to gastroenterologists, with a dearth of standardized recommendations regarding evaluation and management. Areas covered: A recursive literature search was performed using PubMed, Cochrane and Medline databases for original and review articles on SB and obscure gastrointestinal bleeding (OGIB). Based upon the available literature, this review outlines the main challenges and controversies, and provides a practical and cost-effective approach towards SB bleeding. Expert commentary: SB bleeding is suspected in patients with persistent or recurrent bleeding after negative bidirectional endoscopy, and unexplained iron deficiency anemia. Selection of test(s) should be individualized based upon patient presentation and suspicion for type of underlying lesion. Endoscopic or radiologic evaluation and treatment is the mainstay in the majority of patients, while pharmacologic agents may have a role in patients with refractory bleeding, and those unable to undergo evaluation.
小肠出血的检测对胃肠病学家来说仍然是一项挑战，在评估和管理方面缺乏标准化的建议。涵盖领域：使用PubMed、Cochrane和Medline数据库进行了递归文献检索，以查找有关小肠和不明原因胃肠道出血（OGIB）的原始文章和综述文章。基于现有文献，本综述概述了主要挑战和争议，并提供了一种实用且具成本效益的小肠出血处理方法。专家评论：双向内镜检查结果为阴性后仍有持续或反复出血以及不明原因缺铁性贫血的患者怀疑有小肠出血。应根据患者表现和对潜在病变类型的怀疑来个体化选择检查。内镜或放射学评估及治疗是大多数患者的主要治疗手段，而药物治疗可能对难治性出血患者以及无法接受评估的患者有用。
