Diagnosis and treatment of small intestinal bleeding: retrospective analysis of 76 cases.
OBJECTIVE
To investigate the causes of small intestinal bleeding as well as its diagnosis and therapeutic approaches.


METHODS
A retrospective analysis was conducted according to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years.


RESULTS
In these patients, tumor was the most frequent cause of small intestinal bleeding (37/76), followed by Mecke's diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by exploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and enteroanastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications.


CONCLUSIONS
Tumor is the major cause of small intestinal bleeding followed by Meckel's diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction angiography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examination of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleeding.
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; D000368:Aged; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D006417:Hematuria / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult