Cucchiara S, Guandalini S, Staiano A, Devizia B, Capano G, Romaniello G, Poggi V, Tamburrini O, Settimi A, de Ritis G
J Pediatr Gastroenterol Nutr. 1983 Nov;2(4):667-71. doi: 10.1097/00005176-198311000-00017.
The authors evaluated the diagnostic role of sigmoidoscopy, colonoscopy, and double contrast radiology in 103 children with rectal bleeding, with or without other gastrointestinal symptoms. The children's mean age was 44 months, with a range from 1 month to 12 years. In 74.5% of the subjects investigated, visual inspection of the anus and sigmoidoscopy with rectal biopsy disclosed a positive diagnosis. Of the remaining patients, a conclusive diagnosis was reached by either colonoscopy or double contrast radiology in all but six patients. These six, with mild painless hematochezia, remained without a diagnosis. The diagnostic procedure in pediatric patients with rectal bleeding should include an initial visual inspection of the anus, and sigmoidoscopy; air contrast enema and colonoscopy should be performed only in children whose sigmoidoscopy is negative, in diagnostic assessment of inflammatory bowel disease, and in cases of recurrent bleeding after removal of rectal polyps. Colonoscopy is important also in the follow-up examination of children with inflammatory bowel disease and allows the removal of polyps located in the proximal colon.
作者评估了乙状结肠镜检查、结肠镜检查和双重对比放射学检查在103例有或无其他胃肠道症状的直肠出血儿童中的诊断作用。这些儿童的平均年龄为44个月，年龄范围从1个月至12岁。在74.5%接受检查的受试者中，肛门视诊及乙状结肠镜检查并取直肠活检得出了阳性诊断。其余患者中，除6例患者外，均通过结肠镜检查或双重对比放射学检查得出了确定性诊断。这6例有轻度无痛便血的患者仍未确诊。小儿直肠出血患者的诊断程序应包括初步的肛门视诊及乙状结肠镜检查；空气灌肠造影和结肠镜检查仅应在乙状结肠镜检查结果为阴性的儿童、炎症性肠病的诊断评估以及直肠息肉切除术后反复出血的病例中进行。结肠镜检查在炎症性肠病患儿的随访检查中也很重要，并且可以切除位于近端结肠的息肉。
