Application of laparoscopy in diagnosis and treatment of massive small intestinal bleeding: report of 22 cases.
OBJECTIVE
To investigate the diagnostic and therapeutic value of laparoscopy in patients with massive small intestinal bleeding.


METHODS
Twenty-two patients with massive small intestinal bleeding and hemodynamic alteration underwent laparoscopic laparotomy in our unit from December 2002 to April 2005. Post pathologic sites were found, laparoscopy- or laparoscopy-assisted part small intestinal resection including pathologic intestinal site and enteroanastomosis was performed in all these patients.


RESULTS
The bleeding sites were successfully detected by laparoscopy in all these 22 patients. Massive small intestinal bleeding was caused by jejunum benign stromal tumor in 8 cases, by jejunum potential malignant stromal tumor in 5 cases, by jejunum malignant stromal tumor in 1 case, by Mechel's diverticulum in 5 cases, by small intestinal vascular deformity in 2 cases, and by ectopic pancreas in 1 case. A total of 16 patients underwent laparoscopy-assisted enterectomy and enteroanastomosis of small intestine covering the diseased segment and 6 patients received enterectomy of the diseased segment under laparoscope. No surgical complications occurred and the outcome was satisfactory.


CONCLUSIONS
Laparoscopy in diagnosis and treatment of massive small intestinal bleeding is noninvasive with less pain, short recovery time and definite therapeutic efficacy.
Ba
Ming-Chen
MC
Department of General Surgery, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, Guangdong Province, China. bamingchen@163.net
Qing
San-Hua
SH
Huang
Xiang-Cheng
XC
Wen
Ying
Y
Li
Guo-Xin
GX
Yu
Jiang
J
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged