Diagnosis of obscure gastrointestinal bleeding by intraoperative enteroscopy in 81 consecutive patients

瞄准：为了由与流血调查一系列选择病人分析 intra 起作用的肠寄生物(IOE ) 的结果和复杂并发症，怀疑了从小肠发源。方法：81 个病人(吝啬的年龄：65 年) 包括 40，男性(49.4%) 和有阴暗胃肠的流血的 41 女性(50.6%) 经历了在 1990 和 2004 之间的 IOE。病人从一个数据库被识别，数据回顾地从病人的图表被选择。所有病人在 IOE 前经历了至少一非诊断的 esophagogastroduodenoscopy，结肠镜检查，标准肠寄生物和否定腹的超声扫描。结果：在病人的中部的最小的血红素水平是 59 + 15 g/L 并且 72.8% 病人以前要求了包装红血球的输送。流血来源在 68 被检测(84%) 病人在 IOE 期间。Angiodysplasiae 在 44 个病人(54.3%) 被发现， 9 个病人(11.1%) 被溃疡在小肠影响。在小肠的一个肿瘤在另外一个被检测 6 个病人。治疗在大多数病人由 argon-plasma-coagulation，外科的缝术或有限切除术组成了。结论：Intra 起作用的肠寄生物仍然为怀疑的小肠流血的诊断被使用。最近的开发象无线的囊内视镜检查法和两倍汽球肠寄生物那样，以后可以导致 IOE 的代替。

AIM： To analyze the results and complications of intraoperative enteroscopy （IOE） by investigating a series of selected patients with bleeding suspected to originate from the small intestine. METHODS： Eighty-one patients （mean age： 65 years） including 40 males （49.4%） and 41 females （50.6%） with obscure gastrointestinal bleeding underwent IOE between 1990 and 2004. The patients were identified from a database and data were selected from the patients＇ charts retrospectively. All the patients had undergone at least one non-diagnostic esophagogastroduodenoscopy, colonoscopy, standard enteroscopy and a negative abdominal ultrasound scan before IOE. RESULTS： The median minimal hemoglobin level in the patients was 59＋15g/L and 72.8% of the patients required transfusion of packed erythrOoltes previously. A bleeding source was detected in 68 （84%） of the patients during IOE. Angiodysplasiae were found in 44 patients （54.3%） and 9 patients （11.1%） were affected by ulcers in the small intestine. A tumor in the small intestine was detected in another 6 patients. The treatment consisted of argon-plasma-coagulation, surgical suture or limited resection in most of the patients. CONCLUSION： Intra-operative enteroscopy is still used for the diagnosis of suspected small bowel bleeding. Recent developments such as wireless capsule endoscopy and double balloon enteroscopy, may lead to the replacement of IOE in the future.