Department of Gastroenterology, Fujita Health University School of Medicine, Aichi, Japan.
Dig Endosc. 2020 Jan;32(2):204-218. doi: 10.1111/den.13554. Epub 2019 Nov 25.
Small-bowel bleeding accounts for the majority of obscure gastrointestinal bleeding, but it is caused by various types of small bowel disease, upper gastrointestinal disease, and colorectal disease. For the diagnosis, history taking and physical examination are required, leading to a determination of what diseases are involved. Next, cross-sectional imaging, such as computed tomography, should be carried out, followed by the latest enteroscopy such as small bowel capsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient condition. After a comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected. This article reviews recent advances in the endoscopic diagnosis of obscure gastrointestinal bleeding and compares perspectives of the management of obscure gastrointestinal bleeding in Japan with that in other countries.
小肠出血占不明原因胃肠道出血的大部分，但它是由各种类型的小肠疾病、上胃肠道疾病和结直肠疾病引起的。为了诊断，需要进行病史采集和体格检查，以确定涉及哪些疾病。接下来，应进行横断面成像，如计算机断层扫描，然后根据出血的严重程度和患者情况进行小肠胶囊内镜和深部内镜等最新的内镜检查。全面诊断后，应选择药物治疗、内镜治疗或手术治疗。本文综述了不明原因胃肠道出血内镜诊断的最新进展，并比较了日本与其他国家在不明原因胃肠道出血治疗观点上的差异。
