title: Analysis of the causes and clinical characteristics of jejunoileal hemorrhage in China: a multicenter 10 year retrospective survey.
abstract: BACKGROUND
  A retrospective study was performed to assess the causes, diagnostic methods for, and clinical features of, jejunoileal hemorrhage in Shandong province, China and to derive recommendations for management of this condition from these data.
  
  
  METHODS
  We performed a retrospective systematic collection of data from between January 1999 and December 2008 in seven cities in Shandong province, China, identified 72 patients with jejunoileal hemorrhage and analyzed the relevant clinical data.
  
  
  RESULTS
  Overall, tumors were the most common cause of jejunoileal hemorrhage (42 patients, 58.3%). The causes of this condition were significantly different (P < 0.05) in male and female patients. In male patients, the commonest factors were tumor (52.2%), enteritis (17.4%) and angiopathy (15.2%). However, in female patients, tumors accounted for a greater proportion of cases (18/26, 69.2%). In 38 cases (52.8%) the diagnosis was made by intraoperative enteroscopy or laparotomy, in 14 by capsule endoscopy and in the remainder by radiological methods. The most frequent presentation was melena (62.7%), followed by maroon stools (26.9%) and hematochezia (9.0%). Of the 72 patients,laparotomy is the main treatment method.
  
  
  CONCLUSIONS
  Tumor, enteritis and angiopathy and diverticular disease are the most common causes of jejunoileal hemorrhage in Shandong province, China. The main clinical manifestations are bloody stools, most commonly in the form of melena, with or without abdominal pain. We recommend that female patients over the age of 40 with jejunoileal hemorrhage accompanied by abdominal pain should undergo urgent further assessment because of the strong probability of jejunoileal tumor.
authors.affiliation: Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Da-lei
authors.initials: DL
authors.lastname: Jiang
authors.forename: Hui-ya
authors.initials: HY
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Yuan
authors.forename: Jian-chao
authors.initials: JC
authors.lastname: Sui
authors.forename: Chang-chun
authors.initials: CC
authors.lastname: Jing
authors.forename: Kai-tong
authors.initials: KT
authors.lastname: Jiang
authors.forename: Qing-cai
authors.initials: QC
authors.lastname: Wang
authors.forename: Sheng-an
authors.initials: SA
authors.lastname: Yuan
authors.forename: Hai-ying
authors.initials: HY
authors.lastname: Chen
authors.forename: Yan-jing
authors.initials: YJ
authors.lastname: Gao
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004240:Diverticulum / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D004724:Endoscopy / Q000379:methods; D004751:Enteritis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007579:Jejunal Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008551:Melena / Q000175:diagnosis / Q000000981:diagnostic imaging; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult