Digestive hemorrhages of obscure origin.
BACKGROUND
The diagnosis of digestive bleeding in some cases can require a diagnostic laparotomy when other methods have been ineffective. Video-laparoscopy can provide such cases with a certain diagnosis and the possibility of performing a simultaneous surgical treatment.


METHODS
Our experience using video-laparoscopic to treat digestive hemorrhages of obscure origin involved 16 patients. The examined patients presented with the following diseases: Meckel's diverticulum (8 cases), gastric leiomyoma (1 case), small bowel leiomyoma (4 cases), jejunum leiomyosarcoma (1 case), small bowel melanoma (1 case), and Peutz-Jeghers syndrome (1 case).


RESULTS
In all these patients the laparoscopic approach allowed us to identify the origin and site of the hemorrhages, and subsequently to treat the identified lesions. In one patient, an intraperitoneal resection of the diverticulum was performed using Endo-Gia (TM30NIF; Tyco Auto-Suture). In the remaining cases, a minilaparatomy was performed for resection of the disordered loop.


CONCLUSIONS
Video-laparoscopy is very useful for avoiding explorative laparatomies on patients affected by digestive hemorrhages of obscure origin. In these cases, the video-laparoscopic approach allows full and meticulous explorations of the small bowel to be performed, and seems to be useful for diagnosis through direct observation of the lesions. Moreover, if necessary, video-laparoscopy can be used for the effective treatment of the diseases.
Tricarico
A
A
Emergency Department, Laparoscopic Surgery, A.O.R.N. Cardarelli, Via A. Cardarelli, 80100 Naples, Italy. antric@katamail.com
Cione
G
G
Sozio
M
M
Di Palo
P
P
Bottino
V
V
Martino
A
A
Tricarico
T
T
Falco
P
P
D000293:Adolescent; D000328:Adult; D003949:Diagnostic Techniques, Surgical / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000379:methods; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications; D007421:Intestine, Small / Q000473:pathology; D007889:Leiomyoma / Q000150:complications; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications; D008545:Melanoma / Q000150:complications; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology; D013274:Stomach Neoplasms / Q000150:complications; D020535:Video-Assisted Surgery / Q000379:methods