Adrain A L, Krevsky B
Section of Gastroenterology, Temple University Hospital, Philadelphia, Pa 19041, USA.
Dig Dis. 1996 Nov-Dec;14(6):345-55. doi: 10.1159/000171568.
Approximately 5% of all patients with gastrointestinal hemorrhage will not have a bleeding site found after standard evaluation with upper endoscopy and colonoscopy. The source of bleeding in these patients is often the small intestine. In the past 2 decades, our ability to examine the small bowel endoscopically has been enhanced by the use of intraoperative enteroscopy and the development of push and sonde enteroscopes. In a stepwise evaluation of the patient with obscure gastrointestinal bleeding using enteroscopy, the identification of a bleeding source has been reported in 70-100% of patients, usually leading to palliative, if not definitive, therapy. In this review we discuss the indications, methods and yields of each of these procedures, and propose a diagnostic algorithm with which to approach these patients.
在接受上消化道内镜检查和结肠镜检查的标准评估后，约5%的胃肠道出血患者找不到出血部位。这些患者的出血来源通常是小肠。在过去20年中，术中肠镜检查以及推进式和探条式肠镜的发展提高了我们内镜检查小肠的能力。在使用肠镜对不明原因胃肠道出血患者进行逐步评估时，70%-100%的患者可找到出血源，这通常会带来姑息性治疗，即便不是根治性治疗。在本综述中，我们讨论了这些检查方法各自的适应证和产量，并提出了针对这些患者的诊断算法。
