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小肠出血的诊断与管理

Diagnosis and management of small-bowel bleeding.

作者信息

Pennazio Marco, Cortegoso Valdivia Pablo, Triantafyllou Konstantinos, Gralnek Ian M

机构信息

University Division of Gastroenterology, City of Health and Science University Hospital, University of Turin, Turin, Italy.

Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy.

出版信息

Best Pract Res Clin Gastroenterol. 2023 Jun-Aug;64-65:101844. doi: 10.1016/j.bpg.2023.101844. Epub 2023 Jul 4.

Abstract

Small-bowel (SB) bleeding is a challenging problem for the clinician, presenting many pitfalls in both diagnosis and subsequent treatment. Videocapsule endoscopy (VCE) and device-assisted enteroscopy (DAE) have revolutionized the approach to the patient with SB bleeding, allowing for the endoscopic diagnosis and management of what was previously only a surgical matter. The patients' assessment in SB bleeding is of foremost importance, as treatment success relies on a detailed evaluation of clinical history, suspicion for underlying lesions, and a careful selection and timing of diagnostic and therapeutic tools. This review will summarize current state-of-the-art evidence and practice points, to provide the clinician with a comprehensive guide towards the management of SB bleeding.

摘要

小肠出血对临床医生来说是一个具有挑战性的问题,在诊断和后续治疗中存在许多陷阱。视频胶囊内镜检查(VCE)和器械辅助小肠镜检查(DAE)彻底改变了对小肠出血患者的诊疗方法,使以前只能通过手术处理的疾病能够进行内镜诊断和治疗。对小肠出血患者的评估至关重要,因为治疗的成功依赖于对临床病史的详细评估、对潜在病变的怀疑以及对诊断和治疗工具的精心选择和时机把握。本综述将总结当前的最新证据和实践要点,为临床医生提供一份关于小肠出血管理的全面指南。

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