title: Diagnosis and treatment of small intestinal bleeding: retrospective analysis of 76 cases.
abstract: 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.
authors.affiliation: Department of General Surgery, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, Guangdong Province, China. bamingchen@163.net
authors.forename: Ming-Chen
authors.initials: MC
authors.lastname: Ba
authors.forename: San-Hua
authors.initials: SH
authors.lastname: Qing
authors.forename: Xiang-Cheng
authors.initials: XC
authors.lastname: Huang
authors.forename: Ying
authors.initials: Y
authors.lastname: Wen
authors.forename: Guo-Xin
authors.initials: GX
authors.lastname: Li
authors.forename: Jiang
authors.initials: J
authors.lastname: Yu
mesh_terms: 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