Rapid Communication
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 7, 2006; 12(45): 7371-7374
Published online Dec 7, 2006. doi: 10.3748/wjg.v12.i45.7371
Diagnosis and treatment of small intestinal bleeding: Retrospective analysis of 76 cases
Ming-Chen Ba, San-Hua Qing, Xiang-Cheng Huang, Ying Wen, Guo-Xin Li, Jiang Yu
Ming-Chen Ba, San-Hua Qing, Xiang-Cheng Huang, Ying Wen, Guo-Xin Li, Jiang Yu, Department of General Surgery, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, Guangdong Province, China
Correspondence to: Ming-Chen Ba, Department of General Surgery, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, Guangdong Province, China. bamingchen@163.net
Telephone: +86-20-62787625
Received: December 21, 2005
Revised: December 28, 2005
Accepted: October 12, 2006
Published online: December 7, 2006
Abstract

AIM: 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 Meckel’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.

CONCLUSION: 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.

Keywords: Small intestine, Hemorrhage, Neoplasia, Meckel’s diverticulum