Abutalib Hani, Yano Tomonori, Shinozaki Satoshi, Lefor Alan Kawarai, Yamamoto Hironori
Department of Gastroenterology, Beni-Suef University, Qism Bani Sweif, Egypt.
Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Clin Endosc. 2020 Jul;53(4):402-409. doi: 10.5946/ce.2020.143. Epub 2020 Jul 30.
The small bowel had long been considered a dark unapproachable tunnel until the invention of capsule endoscopy and doubleballoon enteroscopy in the 21st century, which revolutionized the diagnosis and management of small bowel diseases, including bleeding. Various imaging modalities such as computed tomographic enterography, angiography, capsule endoscopy, and balloonassisted enteroscopy play vital roles in the diagnosis and management of small bowel bleeding. The choice of modality to use and timing of application differ according to the availability of the modalities, patient's history, and physician's experience. Small bowel bleeding is managed using different strategies as exemplified by medical treatment, interventional radiology, endoscopic therapy, or surgical intervention. Balloon-assisted enteroscopy enables endoscopic interventions to control small bowel bleeding, including electrocautery, argon plasma coagulation, clip application, and tattooing as a prelude to surgery. In this article, we clarify the recent approaches to the optimal diagnosis and management of patients with small bowel bleeding.
在21世纪胶囊内镜和双气囊小肠镜发明之前，小肠长期以来一直被视为一条黑暗且难以触及的通道，而这两项发明彻底改变了包括出血在内的小肠疾病的诊断和治疗方式。计算机断层扫描小肠造影、血管造影、胶囊内镜和气囊辅助小肠镜等各种成像方式在小肠出血的诊断和治疗中发挥着至关重要的作用。使用何种方式以及应用时机的选择会因各种方式的可及性、患者病史和医生经验而有所不同。小肠出血可采用不同的治疗策略，如药物治疗、介入放射学、内镜治疗或手术干预。气囊辅助小肠镜能够进行内镜干预以控制小肠出血，包括电灼、氩离子凝固术、夹子应用以及作为手术前奏的标记。在本文中，我们阐明了小肠出血患者最佳诊断和治疗的最新方法。
